| Organization Name: | 395061 MED EVAL |
| NPI Number: | 1508034414 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANGIE C TANSOR (REIMBURSEMENT OFFICER I) |
| Mailing Address: | 4200 North Oak Park Avenue Chicago |
| State: | IL US |
| Postal Code: | 606341417 |
| Phone Number: | 7737943733 |
| Fax Number: | 7737944046 |
| NPI Enumeration Date: | 02/13/2008 |
| NPI Last Update Date: | 02/13/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 273R00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Hospital Units |
| Taxonomy Classification: | Psychiatric Unit |
| Taxonomy Specialization: | |
| Taxonomy Definition: | In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians |