NPIMap

Organization Active NPI

Advocate Condell Medical Center

  • General Acute Care Hospital
  • Libertyville, IL
National Provider Identifier
1124272547
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
0000422 Issued in IL
Legal business name
ADVOCATE CONDELL MEDICAL CENTER
Practice address
801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone
(847) 362-2900
Fax
(847) 573-4304
NPI assigned
Nov 12, 2008
Last updated
Jan 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Authorized official

Name
Kara Richardson
Title
VP Managed Health
Phone
(980) 416-4068

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0000422 IL Primary
Clinical Medical Laboratory 291U00000X NU

Addresses

Primary practice location

801 S Milwaukee Ave
Libertyville, IL 60048-3204

Mailing address

900 Garfield Ave
Libertyville, IL 60048-3141
Phone (847) 362-2900

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090122000249 IL Part A Provider - Hospital 9133283013 2 other NPIs on this enrollment
Practice locations: Gurnee, IL; Grayslake, IL; Vernon Hills, IL; Round Lake Beach, IL; Lincolnshire, IL; Libertyville, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124272547. Details of each certification follow.

Hospital certification: CCN 140202

Legal name
ADVOCATE CONDELL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Dec 12, 2019
Beds
284
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
801 S Milwaukee Ave
Libertyville, IL 60048-3204
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Advocate Condell Medical CenterCCN 140202 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Advocate Good Samaritan4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

97158 Eagle Way
Chicago, IL 60678

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Dia Nichols Individual Corporate OfficerPresident Oct 1, 2024
Corporate Director Oct 1, 2024
Advocate Health Care Network Organization, Oak Brook, IL Non-profit 5% Or Greater Indirect Ownership Interest Dec 1, 2008 100%
Gail D Hasbrouck Individual Corporate DirectorDirector Jan 8, 2018
Clarence Nixon Individual Corporate OfficerChairperson Jan 1, 2025
Corporate Director Oct 1, 2005
Tori Munnik Individual Corporate OfficerAssistant Treasurer Jun 3, 2026
Rachelle Hart Individual Corporate OfficerSecretary Jun 14, 2023
Kara Richardson Individual Corporate OfficerAssistant Treasurer Oct 1, 2024
David B Anderson Individual Corporate Director Oct 1, 2008
Iliana Mora Individual W-2 Managing EmployeeHospital President Nov 3, 2025
Lindsay Durgin Individual Corporate OfficerTreasurer Jul 1, 2025
Rachel Halverson Individual Corporate OfficerAssistant Treasurer Jun 14, 2023
Desiree Millet Individual Corporate OfficerAssistant Treasurer Jun 3, 2026
Nathaniel L Edmond Individual Corporate OfficerVice Chairperson Jan 1, 2025
Corporate Director Jun 1, 2013
Harold James Jr Slinkman Individual Corporate OfficerAssistant Secretary Jun 14, 2023
Advocate Health and Hospitals Corporation Organization, Oak Brook, IL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 1, 2008 100%
Advocate Health Inc Organization, Charlotte, NC Corporation, Non-profit Operational/Managerial Control Dec 2, 2022
Mark M Harris Individual Corporate Director Oct 1, 2005
Advocate Aurora Health, Inc. Organization, Milwaukee, WI Created for acquisition, Corporation, Holding company, Non-profit 5% Or Greater Indirect Ownership Interest Apr 1, 2018 100%
Operational/Managerial Control Apr 1, 2018 100%
Kathie S Bender Schwich Individual Corporate Director Jun 11, 2023

Facilities with the same owner 92

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

View all 92

Practitioners & affiliated clinicians

Affiliated clinicians 848

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 848

NPI Registry JSON

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1124272547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 GARFIELD AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483141",
            "telephone_number": "847-362-2900",
            "fax_number": "847-573-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483204",
            "telephone_number": "847-362-2900",
            "fax_number": "847-573-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCATE CONDELL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-12",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "KARA",
        "authorized_official_title_or_position": "VP MANAGED HEALTH",
        "authorized_official_telephone_number": "980-416-4068"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "0000422",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.