Provider Type Icon

PRESENCE SAINT JOSEPH HOSPITAL NPI 1124116876


NPI Information

NPI: 1124116876
Provider Name: PRESENCE SAINT JOSEPH HOSPITAL

Doing Business As: LABOURE OUTPATIENT

Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
2900 NORTH LAKESHORE DRIVE
1ST FLOOR CLINIC
CHICAGO, IL
ZIP 60657
Phone: (773) 665-3080
Get Directions

PRESENCE SAINT JOSEPH HOSPITAL is an internal medicine in Chicago, IL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PRESENCE SAINT JOSEPH HOSPITAL NPI is 1124116876. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Laboure Outpatient.

The provider's business location address is:

2900 NORTH LAKESHORE DRIVE
1ST FLOOR CLINIC
CHICAGO, IL
ZIP 60657-000
Phone: (773) 665-3080
Fax: (773) 665-3498

The provider's authorized official is Melvonne Wickliffe-jones .
The authorized official title is Credentialing Mgr and has the following contact phone number (630) 914-2417.

The enumeration date for this NPI number is 10/10/2006 and was last updated on 4/11/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207K00000XAllergy & ImmunologyNo
2207N00000XDermatologyNo
3207RI0200XInternal MedicineInfectious DiseaseNo
4207RR0500XInternal MedicineRheumatologyNo
5207V00000XObstetrics & GynecologyNo
6207W00000XOphthalmologyNo
7207Y00000XOtolaryngologyNo
8208000000XPediatricsNo
92084P0800XPsychiatry & NeurologyPsychiatryNo
10208600000XSurgeryNo
11208800000XUrologyNo
12207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11632129OTHERILLINOISBCBS PROVIDER #
2988270MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.