Provider Demographics
NPI:1730276205
Name:MICHAEL REESE HOSPITAL & MEDICAL CENTER
Entity type:Organization
Organization Name:MICHAEL REESE HOSPITAL & MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CENTER COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN, CDE
Authorized Official - Phone:312-791-2205
Mailing Address - Street 1:2929 S ELLIS
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-3390
Mailing Address - Country:US
Mailing Address - Phone:312-791-2205
Mailing Address - Fax:
Practice Address - Street 1:2929 S ELLIS
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-3390
Practice Address - Country:US
Practice Address - Phone:312-791-2205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty