Ravenswood Physician Associates

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

RAVENSWOOD PHYSICIAN ASSOCIATES

Practice address

4100 N Lincoln Ave
Chicago, IL 60618-3028

Phone

(773) 868-2000

Fax

(773) 248-6659

NPI assigned

Apr 23, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Damon V Morse

Title

President and Ceo

Phone

(773) 868-2004

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114145588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183028",
            "telephone_number": "773-868-2000",
            "fax_number": "773-248-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183028",
            "telephone_number": "773-868-2000",
            "fax_number": "773-248-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVENSWOOD PHYSICIAN ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORSE",
        "authorized_official_first_name": "DAMON",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "773-868-2004",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ravenswood Family Practice
• Ravenswood Health and Wellness Center, S.C.
• Ravenswood Health Center, P.C.
• Ravenswood Pediatrics SC
• Ravenswood Pharmacy Inc
• Ravenswood SLF, LLC
• Ravi Badlani MDSC
• Arun Ravi
• Sai Susmitha Ravi
• Joel Ravichandar

• Health Maintenance Organization in Chicago, IL
• Providers in Chicago, IL by specialty
• Health Maintenance Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.