Provider Demographics
NPI:1730833088
Name:GOOD SAMARITAN HOSPITAL
Entity type:Organization
Organization Name:GOOD SAMARITAN HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-575-3323
Mailing Address - Street 1:PO BOX 93548
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-3548
Mailing Address - Country:US
Mailing Address - Phone:630-575-3323
Mailing Address - Fax:630-645-4602
Practice Address - Street 1:3815 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1500
Practice Address - Country:US
Practice Address - Phone:630-575-3323
Practice Address - Fax:630-645-4602
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOOD SAMARITAN HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital