Illinois Masonic Hospital

Primary specialty

Women's HospitalTaxonomy code 282NW0100X

License

209.010657 Issued in IL

Legal business name

ILLINOIS MASONIC HOSPITAL

Practice address

3048 N Wilton Ave
3Rd Floor
Chicago, IL 60657-6710

Phone

(773) 296-3098

NPI assigned

Sep 25, 2013

Organization subpart

No

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

Authorized official

Name

Lise Hauser, CNM

Title

Supervisor of CNM Services

Phone

(773) 296-3098

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1083040786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3048 N WILTON AVE",
            "address_2": "3RD FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3048 N WILTON AVE",
            "address_2": "3RD FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576710",
            "telephone_number": "773-296-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS MASONIC HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-25",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "HAUSER",
        "authorized_official_first_name": "LISE",
        "authorized_official_title_or_position": "SUPERVISOR OF CNM SERVICES",
        "authorized_official_telephone_number": "773-296-3098",
        "authorized_official_credential": "CNM"
    },
    "taxonomies": [
        {
            "code": "282NW0100X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Women",
            "state": "IL",
            "license": "209.010657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Illinois Kidney Care PLLC
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• Illinois Medical Group SC
• Illinois Medical Specialists PC
• Illinois Mobile Foot Care LLC

• Women's Hospital in Chicago, IL
• Providers in Chicago, IL by specialty
• Women's Hospital in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.