Provider Demographics
NPI:1902074784
Name:LOUIS A WEISS MEMORAIL HOSPITAL
Entity Type:Organization
Organization Name:LOUIS A WEISS MEMORAIL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERIFIED SURGICAL ASSISTANTS
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAKKA VENKAT
Authorized Official - Middle Name:ARUNA
Authorized Official - Last Name:KUMARI
Authorized Official - Suffix:
Authorized Official - Credentials:MBBS9(OSM)
Authorized Official - Phone:630-395-9105
Mailing Address - Street 1:2400 DANBURY DR
Mailing Address - Street 2:UINT-2
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-2091
Mailing Address - Country:US
Mailing Address - Phone:630-395-9105
Mailing Address - Fax:630-395-9105
Practice Address - Street 1:2400 DANBURY DR
Practice Address - Street 2:UNITB-2
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-2091
Practice Address - Country:US
Practice Address - Phone:630-395-9105
Practice Address - Fax:630-395-9105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL282N00000X, 282NW0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No282NW0100XHospitalsGeneral Acute Care HospitalWomen