NPIMap

Organization Active NPI

Thorek Memorial Hospital

Doing business as Andersonville Supportive Living

  • Assisted Living Facility
  • Chicago, IL
National Provider Identifier
1316705528
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
THOREK MEMORIAL HOSPITAL
Doing business as
Andersonville Supportive Living
Practice address
4950 N Ashland Ave
Chicago, IL 60640-3477
Phone
(773) 989-1501
NPI assigned
Mar 12, 2024
Last updated
Mar 12, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
THOREK MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Authorized official

Name
Tim Heinrich
Title
Chief Financial Officer
Phone
(773) 975-6806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

4950 N Ashland Ave
Chicago, IL 60640-3477

Mailing address

4950 N Ashland Ave
Chicago, IL 60640-3477
Phone (773) 989-1501

Other names 1

  • Andersonville Supportive Living Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Thorekk Hosp5 organizations share this tax ID, including this one
Part of
Thorekk Hosp

Other organizations with this tax ID 4

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": "1710201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1316705528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403477",
            "telephone_number": "773-989-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403477",
            "telephone_number": "773-989-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOREK MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THOREK MEMORIAL HOSPITAL",
        "enumeration_date": "2024-03-12",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "HEINRICH",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "773-975-6806"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Andersonville Supportive Living",
            "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 Mar 12, 2024; 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.