NPIMap

Organization Active NPI

Presence Central and Suburban Hospitals Network

  • Health Educator
  • Elgin, IL
National Provider Identifier
1194480640
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Legal business name
PRESENCE CENTRAL AND SUBURBAN HOSPITALS NETWORK
Practice address
77 N Airlite Street
Diabetes Services
Elgin, IL 60123-4912
Phone
(847) 695-3200
Fax
(847) 931-5742
NPI assigned
Nov 1, 2021
Organization subpart
Yes
Parent organization
PRESENCE CHICAGO HOSPITALS NETWORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Mary Jo Mackniskas
Title
Sr. Director, Net Revenue & Reimb
Phone
(773) 213-0776

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health EducatorGroup: 193400000X SINGLE SPECIALTY GROUP 174H00000X Primary

Addresses

Primary practice location

77 N Airlite Street
Diabetes Services
Elgin, IL 60123-4912

Mailing address

77 N Airlite Street
Diabetes Services
Elgin, IL 60123-4912
Phone (847) 695-3200

Other names 1

  • AMITA Saint Joseph Hospital, Elgin Diabetic Services Other name

National Provider Directory

National Provider Directory
Tax ID family
St Joseph Medcial Cente16 organizations share this tax ID, including this one
Part of
Presence Chicago Hospitals

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1194480640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 N AIRLITE STREET",
            "address_2": "DIABETES SERVICES",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234912",
            "telephone_number": "847-695-3200",
            "fax_number": "847-931-5742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 N AIRLITE STREET",
            "address_2": "DIABETES SERVICES",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234912",
            "telephone_number": "847-695-3200",
            "fax_number": "847-931-5742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE CENTRAL AND SUBURBAN HOSPITALS NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESENCE CHICAGO HOSPITALS NETWORK",
        "enumeration_date": "2021-11-01",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "MACKNISKAS",
        "authorized_official_first_name": "MARY JO",
        "authorized_official_title_or_position": "SR. DIRECTOR, NET REVENUE & REIMB",
        "authorized_official_telephone_number": "773-213-0776"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMITA Saint Joseph Hospital, Elgin Diabetic Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.