Provider Demographics
NPI:1962719930
Name:JOHN H STROGER HOSPITAL OF COOK COUNTY
Entity type:Organization
Organization Name:JOHN H STROGER HOSPITAL OF COOK COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUJA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-864-7229
Mailing Address - Street 1:1926 W HARRISON ST
Mailing Address - Street 2:MEDICAL CENTER APARTMENT,#1109
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3737
Mailing Address - Country:US
Mailing Address - Phone:617-803-8736
Mailing Address - Fax:
Practice Address - Street 1:1926 W HARRISON ST
Practice Address - Street 2:MEDICAL CENTER APARTMENT,#1109
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3737
Practice Address - Country:US
Practice Address - Phone:617-803-8736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-11
Last Update Date:2010-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125057324282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital