| Jackson Park Hospital Foundation | |
|
7531 S Stony Island Ave Chicago IL 60649-3954 | |
| (773) 947-7500 | |
| (773) 947-7339 |
| Full Name | Jackson Park Hospital Foundation |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 7531 S Stony Island Ave, Chicago, Illinois |
| Authorized Official Name and Position | Merritt J. Hasbrouck (PRESIDENT) |
| Authorized Official Contact | 7739477500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Park Hospital Foundation 7531 S Stony Island Ave Chicago IL 60649-3954 Ph: (773) 947-7500 | Jackson Park Hospital Foundation 7531 S Stony Island Ave Chicago IL 60649-3954 Ph: (773) 947-7500 |
| NPI Number | 1497750699 |
|---|---|
| Provider Enumeration Date | 06/15/2005 |
| Last Update Date | 01/28/2020 |
| Certification Date | 01/28/2020 |
| Medicare PECOS PAC ID | 2163567843 |
|---|---|
| Medicare Enrollment ID | O20110311000387 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497750699 | NPI | - | NPPES |
| 0026 | Other | IL | BLUECROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 0001115 (Illinois) | Secondary |
| 282N00000X | General Acute Care Hospital | 0001115 (Illinois) | Primary |
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