Provider Demographics
NPI:1487916169
Name:SAINT MARYS AND ELIZABETH MEDICAL CENTRE
Entity type:Organization
Organization Name:SAINT MARYS AND ELIZABETH MEDICAL CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRISIS WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MBBS
Authorized Official - Phone:312-770-2000
Mailing Address - Street 1:2233 W DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-8151
Mailing Address - Country:US
Mailing Address - Phone:312-770-2000
Mailing Address - Fax:
Practice Address - Street 1:2233 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-8151
Practice Address - Country:US
Practice Address - Phone:312-770-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty