Basic Information
| Provider Information | |||||||||
| NPI: | 1245494350 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VHS ACQUISITION SUBSIDIARY NUMBER 3 INC | ||||||||
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| OtherOrganizationName: | LOUIS A WEISS MEMORIAL HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 BURTON HILLS BLVD | ||||||||
| Address2: | SUITE 100, ATTENTION, CAROL BAILEY | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372156197 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156656000 | ||||||||
| FaxNumber: | 6156656184 | ||||||||
| Practice Location | |||||||||
| Address1: | 4646 N MARINE DR | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606405759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7738788700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2008 | ||||||||
| LastUpdateDate: | 10/28/2013 | ||||||||
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| AuthorizedOfficialLastName: | BAILEY | ||||||||
| AuthorizedOfficialFirstName: | CAROL | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6156656000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | VHS ACQUISITION SUBSIDIARY NUMBER 3 INC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | 14D1002692 | IL | Y | Laboratories | Clinical Medical Laboratory |
No ID Information.