NPIMap

Organization Active NPI

Roseland Community Hospital Association

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1265997142
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ROSELAND COMMUNITY HOSPITAL ASSOCIATION
Practice address
45 W 111TH St
Chicago, IL 60628-4200
Phone
(773) 995-3000
Fax
(773) 995-0664
NPI assigned
Feb 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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

Authorized official

Name
Robert Vais
Title
Cfo
Phone
(773) 995-3044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

45 W 111TH St
Chicago, IL 60628-4200

Mailing address

45 W 111TH St
Chicago, IL 60628-4200
Phone (773) 995-3000

Other names 1

  • ROSELAND COMMUNITY HOSPITAL DENTAL PROGRAM Other name

National Provider Directory

National Provider Directory
Tax ID family
Roseland Community Hospit3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1549324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549324800000",
    "number": "1265997142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284200",
            "telephone_number": "773-995-3000",
            "fax_number": "773-995-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284200",
            "telephone_number": "773-995-3000",
            "fax_number": "773-995-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSELAND COMMUNITY HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A",
        "authorized_official_last_name": "VAIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "773-995-3044"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROSELAND COMMUNITY HOSPITAL DENTAL PROGRAM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Feb 5, 2019; 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.