Provider Demographics
NPI:1902958564
Name:ST STEVEN MEDICAL CENTER LTD
Entity Type:Organization
Organization Name:ST STEVEN MEDICAL CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NADER
Authorized Official - Middle Name:N
Authorized Official - Last Name:TOBIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-425-6225
Mailing Address - Street 1:11685 ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60480-1652
Mailing Address - Country:US
Mailing Address - Phone:708-670-6470
Mailing Address - Fax:708-425-3456
Practice Address - Street 1:4400 W 95TH ST STE 404
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-7216
Practice Address - Country:US
Practice Address - Phone:708-425-6225
Practice Address - Fax:708-425-3456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty