NPIMap

Organization Active NPI

Saint Anthony Pho, LLC

  • Health Maintenance Organization
  • Chicago, IL
National Provider Identifier
1164703823
Registry record updated Sep 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
SAINT ANTHONY PHO, LLC
Practice address
2875 W 19TH St
Chicago, IL 60623-3501
Phone
(773) 484-4015
NPI assigned
Sep 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2011

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

Authorized official

Name
Ms. Aileen M Brooks
Title
Executive Committee Member
Phone
(773) 484-4015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

2875 W 19TH St
Chicago, IL 60623-3501

Mailing address

2875 W 19TH St
Chicago, IL 60623-3501
Phone (773) 484-4015

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315353600000",
    "number": "1164703823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 W 19TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233501",
            "telephone_number": "773-484-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 W 19TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233501",
            "telephone_number": "773-484-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT ANTHONY PHO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-07",
        "last_updated": "2011-09-07",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "AILEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE COMMITTEE MEMBER",
        "authorized_official_telephone_number": "773-484-4015",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "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 Sep 7, 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.

Verify at the official NPI Registry.