NPI 1164517462

Saint Mary of Nazareth Pho

Organisation Health Maintenance Organization Chicago, IL

Practice location

Address: 1021 West Adams Street Suite 300, Chicago, IL 60607
Phone: (773) 572-8300
Fax: (312) 455-9485

Authorised official

Name: Elizabeth Stackpole Koch
Title: Director of Contracting
Phone: (773) 572-8331

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X

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Registry record

NPI: 1164517462
Entity type: Organization
NPI issued: 3 Oct 2006
Record last updated: 22 Aug 2020

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.