Provider Demographics
NPI:1700635190
Name:ST BERNARD HOSPITAL & HEALTH CARE CENTER
Entity type:Organization
Organization Name:ST BERNARD HOSPITAL & HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:SPRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-962-4210
Mailing Address - Street 1:326 W 64TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60621-3114
Mailing Address - Country:US
Mailing Address - Phone:773-962-3900
Mailing Address - Fax:
Practice Address - Street 1:6307 S STEWART AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60621-3116
Practice Address - Country:US
Practice Address - Phone:773-420-1573
Practice Address - Fax:773-420-1851
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST BERNARD HOSPITAL & HEALTH CARE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty