Provider Demographics
NPI:1831194182
Name:FRANCISCAN HEALTH DYER & HAMMOND
Entity type:Organization
Organization Name:FRANCISCAN HEALTH DYER & HAMMOND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:GOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-932-2300
Mailing Address - Street 1:3224 RIDGE RD
Mailing Address - Street 2:STE 202&203
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-3129
Mailing Address - Country:US
Mailing Address - Phone:708-418-5543
Mailing Address - Fax:708-418-8005
Practice Address - Street 1:3224 RIDGE RD
Practice Address - Street 2:STE 202&203
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-3129
Practice Address - Country:US
Practice Address - Phone:708-418-5543
Practice Address - Fax:708-418-8005
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCISCAN ST. MARGARET HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-14
Last Update Date:2016-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010198251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
14-7302Medicare ID - Type Unspecified