NPIMap

Organization Active NPI

St. Joseph Hospital

Doing business as SJH Pediatric Opthalmology

  • Pediatric Optometrist
  • Chicago, IL
National Provider Identifier
1194939215
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric OptometristTaxonomy code 152WP0200X
License
036074319 Issued in IL
Legal business name
ST. JOSEPH HOSPITAL
Doing business as
SJH Pediatric Opthalmology
Practice address
2900 N Lake Shore Dr.
Chicago, IL 60657
Phone
(773) 665-3000
NPI assigned
May 9, 2007
Last updated
Aug 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Authorized official

Name
Mr. Ronald E Struxness
Title
Chief Executive Officer
Phone
(773) 665-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X 036074319 IL Primary

Addresses

Primary practice location

2900 N Lake Shore Dr.
Chicago, IL 60657

Mailing address

1 Transam Plaza Dr.
Suite 490
Oakbrook Terrace, IL 60181
Phone (630) 424-1122

Other identifiers 1

IdentifierTypeStateIssuer
01632129OtherILBCBS OF IL GROUP PROVIDER

Other names 1

  • SJH Pediatric Opthalmology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Saint Joseph Hospital7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1194939215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TRANSAM PLAZA DR.",
            "address_2": "SUITE 490",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "60181",
            "telephone_number": "630-424-1122",
            "fax_number": "630-424-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N LAKE SHORE DR.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-665-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "STRUXNESS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "773-665-3000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "IL",
            "license": "036074319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL GROUP PROVIDER",
            "identifier": "01632129",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SJH Pediatric Opthalmology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 4, 2008; 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.