NPIMap

Organization Active NPI

Insight Chicago, Inc.

Doing business as Insight Hospital & Medical Center Chicago

  • Psychiatric Hospital Unit
  • Chicago, IL
National Provider Identifier
1043297401
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
362170152 Issued in IL
Legal business name
INSIGHT CHICAGO, INC.
Doing business as
Insight Hospital & Medical Center Chicago
Practice address
2525 S Michigan Ave
Chicago, IL 60616-2333
Phone
(312) 567-2000
Fax
(312) 567-6156
NPI assigned
Dec 28, 2005
Last updated
Oct 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robin Cole
Title
Credentialing Specialist
Phone
(810) 275-9333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 362170152 IL Primary

Addresses

Primary practice location

2525 S Michigan Ave
Chicago, IL 60616-2333

Mailing address

PO Box 776473
Chicago, IL 60677-6473
Phone (312) 567-2000

Other identifiers 5

IdentifierTypeStateIssuer
00035OtherILBCBSIL
362170152004MedicaidIL
11727OtherILCITY OF CHICAGO
006247OtherILSTATE OF ILLINOIS LICENSE
362170152001MedicaidIL

Other names 1

  • Insight Hospital & Medical Center Chicago Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210723003057 IL Part A Provider - Hospital 2860894706 Practice locations: Chicago, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043297401. Details of each certification follow.

Hospital certification: CCN 14S158

Legal name
INSIGHT CHICAGO INC
Doing business as
INSIGHT HOSPITAL AND NEDICAL CENTER CHICAGO
Organization structure
CorporationNon-profit
Incorporated
Jun 1, 2021 in IL
Enrollment address
2525 S Michigan Ave
Chicago, IL 60616-2315
Main/Primary Hospital Location
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Insight Chicago Inc35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Nadir Ijaz Individual Corporate Officer Jun 1, 2021
W-2 Managing Employee Jun 1, 2021 100%
Insight Chicago Inc Organization, Chicago, IL Non-profit 5% Or Greater Direct Ownership Interest Jun 1, 2021 100%
Jawad Shah Individual Corporate DirectorBoard Member Jun 1, 2021
Baseer Tajuddin Individual Corporate OfficerBoard Member Jun 1, 2021
Ali Madha Individual Corporate OfficerBoard Member Jun 1, 2021
Robin Cole Individual W-2 Managing EmployeeCredentialing Specialist Jun 1, 2021
Patrice Griffin Individual W-2 Managing EmployeeCredentialing Specialist Jun 1, 2021
Naveed K Mallick Individual Corporate OfficerBoard Member Jun 1, 2021
Atif Bawahab Individual Corporate OfficerCeo Jun 1, 2021 100%

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Insight Hospital and Medical Center ChicagoChicago, IL, CCN 140158 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2021
Insight Hospital and Medical Center ChicagoChicago, IL, CCN 14T158 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2021

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Insight Chicago, Inc.

    dba Insight Hospital & Medical Center Chicago

    • Rehabilitation Hospital Unit
    • Chicago, IL
    • NPI 1154308518

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Insight Chicago, Inc.

    dba Insight Hospital & Medical Center Chicago

    • General Acute Care Hospital
    • Chicago, IL
    • NPI 1730166224

    5% Or Greater Direct Ownership Interest

    CMS ownership

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1043297401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776473",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776473",
            "telephone_number": "312-567-2000",
            "fax_number": "312-638-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162333",
            "telephone_number": "312-567-2000",
            "fax_number": "312-567-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSIGHT CHICAGO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "810-275-9333"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "IL",
            "license": "362170152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "00035",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362170152004",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITY OF CHICAGO",
            "identifier": "11727",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS LICENSE",
            "identifier": "006247",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362170152001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Insight Hospital & Medical Center Chicago",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.