Active NPI
Jesse Brown VA Medical Center
- VA Clinic/Center
- Chicago, IL
National Provider Identifier
1093011702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- VA Clinic/Center
- License
- 036037238
- Legal business name
- JESSE BROWN VA MEDICAL CENTER
- Practice address
- 820 S Damen Ave
Chicago, IL 60612-3728 - Phone
- (312) 569-7271
- NPI assigned
- Jan 28, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. S. Joseph Maurice, MD
- Title
- Consultant
- Phone
- (312) 569-7271
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| VA Clinic/Center | 261QV0200X | 036037238 | IL | Primary |
Addresses
Primary practice location
820 S Damen Ave
Chicago, IL 60612-3728
Mailing address
6544 N Longmeadow Ave
Lincolnwood, IL 60712-3206
Phone (847) 933-0093
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296172800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1296172800000",
"number": "1093011702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6544 N LONGMEADOW AVE",
"city": "LINCOLNWOOD",
"state": "IL",
"postal_code": "607123206",
"telephone_number": "847-933-0093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 S DAMEN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123728",
"telephone_number": "312-569-7271"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JESSE BROWN VA MEDICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2011-01-28",
"last_updated": "2011-01-28",
"status": "A",
"authorized_official_last_name": "MAURICE",
"authorized_official_first_name": "S. JOSEPH",
"authorized_official_title_or_position": "CONSULTANT",
"authorized_official_telephone_number": "312-569-7271",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QV0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, VA",
"state": "IL",
"license": "036037238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.