Basic Information
| Provider Information | |||||||||
| NPI: | 1194880310 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | THSC LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | NEUROLOGIC & ORTHOPEDIC INSTITUTE OF CHICAGO | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4501 N WINCHESTER AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606405265 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7732500000 | ||||||||
| FaxNumber: | 7732500497 | ||||||||
| Practice Location | |||||||||
| Address1: | 4501 N WINCHESTER AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606405265 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7732500000 | ||||||||
| FaxNumber: | 7732500497 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2006 | ||||||||
| LastUpdateDate: | 08/24/2007 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | CAMERON | ||||||||
| AuthorizedOfficialFirstName: | DENISE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VP MANAGED CARE | ||||||||
| AuthorizedOfficialTelephone: | 7732501119 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 1820486 | IL | Y | Hospitals | General Acute Care Hospital |
No ID Information.