NPIMap

Organization Active NPI

St James Hospital and Clinics

  • General Acute Care Hospital
  • Olympia Fields, IL
National Provider Identifier
1063828481
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
125.064852 Issued in IL
Legal business name
ST JAMES HOSPITAL AND CLINICS
Practice address
20201 Crawford Ave
Olympia Fields, IL 60461-1010
Phone
(708) 747-4000
NPI assigned
Jul 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Authorized official

Name
Ryan Wagner, D.O.
Title
Resident
Phone
(920) 585-2839

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 125.064852 IL Primary

Addresses

Primary practice location

20201 Crawford Ave
Olympia Fields, IL 60461-1010

Mailing address

474 N Lake Shore Dr
Apt. 4106
Chicago, IL 60611-3400

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444780800000",
    "number": "1063828481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 N LAKE SHORE DR",
            "address_2": "APT. 4106",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20201 CRAWFORD AVE",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611010",
            "telephone_number": "708-747-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JAMES HOSPITAL AND CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-07",
        "last_updated": "2015-10-14",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "RESIDENT",
        "authorized_official_telephone_number": "920-585-2839",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "125.064852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.