Oak Street Health: Edgewater

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

OAK STREET HEALTH: EDGEWATER

Practice address

1541 W Devon Ave
Chicago, IL 60660-1313

Phone

(312) 810-8763

NPI assigned

Jun 21, 2013

Last updated

Jun 21, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

OAK STREET HEALTHAs reported in NPPES

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

Authorized official

Name

Dr. Griffin Myers, M.D.

Title

Chief Medical Officer

Phone

(773) 412-3000

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Oak Street Health PC2 organizations share this tax ID, including this one

Part of

Oak Street Health PC

Other organizations with this tax ID 1

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

• Oak Street Health Physicians Group PC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1144660085
  NPD tax ID

Locations

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371772800000",
    "number": "1194164202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 W BELDEN AVE",
            "address_2": "#3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601313",
            "telephone_number": "312-810-8763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK STREET HEALTH: EDGEWATER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OAK STREET HEALTH",
        "enumeration_date": "2013-06-21",
        "last_updated": "2013-06-21",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "GRIFFIN",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "773-412-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oak Lab Services Inc
• Oak Leaf Consulting Group, LLC
• Oak Park Dental Group
• Oak Street Health Physicians Group PC
• Oak Street Health Physicians Group, PC
• Oak Street Physician Services LLC
• Oak Tree Developmental Center
• Corinne E Oak-Schecter, M.S. CCC-SLP
• Alison H Oakes, LCSW
• Diana Oakes, NP

• Primary Care Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.