Mercy Crystal Lake Ob Gyn

LBN: Mercy Health System Corporation
Mercy Crystal Lake Ob Gyn is an health care organization with primary practice located at 750 E Terra Cotta Ave Ste B, Crystal Lake IL 60014-3621. The organization recently has only one registered license in Suppliers / Durable Medical Equipment & Medical Supplies, which is considered as the primary health care specialty. Mercy Health System Corporation can be contacted via phone (815) 459-1212, or through Cook, John W via phone (608) 756-6000.

Contact Information

Primary practice address
750 E Terra Cotta Ave Ste B Crystal Lake IL 60014-3621
Phone: (815) 459-1212
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Cook, John W
Phone: (608) 756-6000

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 310800 Wisconsin

Profile Details

NPI number 1508983784
LBN Legal business name Mercy Health System Corporation
DBA Doing business as Mercy Crystal Lake Ob Gyn
Authorized official Cook, John W
Entity Organization
Organization subpart 1 Yes
Enumeration date Mar 23rd, 2007
Last updated Jan 6th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508983784 NPPES
Other 14D0411934 CLIA

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