Provider Demographics
NPI:1053347484
Name:SWEDISH COVENANT PHYSICIAN PARTNERS, LTD.
Entity type:Organization
Organization Name:SWEDISH COVENANT PHYSICIAN PARTNERS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:
Authorized Official - Last Name:CULLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-271-0880
Mailing Address - Street 1:2740 W FOSTER AVE
Mailing Address - Street 2:SUITE 411
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3500
Mailing Address - Country:US
Mailing Address - Phone:773-271-0880
Mailing Address - Fax:
Practice Address - Street 1:2740 W FOSTER AVE
Practice Address - Street 2:SUITE 411
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3500
Practice Address - Country:US
Practice Address - Phone:773-271-0880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization