NPI 1104922533

Jesse Brown VA

Organisation Chronic Disease Hospital Chicago, IL

Practice location

Address: 820 S Damen Ave, Chicago, IL 60612-3728
Phone: (312) 569-7718
Mailing address: 16908 Ingleside Ave, South Holland, IL 60473-3063

Authorised official

Name: Shirley Ann Campbell
Title: Ambulatory Care Nurse
Phone: (312) 569-7718

Registered specialties

Chronic Disease Hospital Primary

Hospitals Taxonomy 281P00000X Licence 041244811 (IL)

Other Chronic Disease Hospital providers in Illinois →

Registry record

NPI: 1104922533
Entity type: Organization
NPI issued: 15 Sep 2006
Record last updated: 19 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.