NPIMap

Organization Active NPI

Mercy Hospital & Medical Center Dasa

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Chicago, IL
National Provider Identifier
1356517544
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
007 Issued in IL
Legal business name
MERCY HOSPITAL & MEDICAL CENTER DASA
Practice address
2525 S Michigan Ave
B-522
Chicago, IL 60616-2333
Phone
(312) 567-6691
Fax
(312) 567-6156
NPI assigned
May 7, 2008
Organization subpart
Yes
Parent organization
MERCY HOSPITAL & MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Thomas J Garvey
Title
VP Finance Cfo
Phone
(312) 567-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 007 IL Primary

Addresses

Primary practice location

2525 S Michigan Ave
B-522
Chicago, IL 60616-2333

Mailing address

2525 S Michigan Ave
B-522
Chicago, IL 60616-2333
Phone (312) 567-6691

Other identifiers 2

IdentifierTypeStateIssuer
35OtherILBCBSIL
14-0158OtherILMEDICARE BL'G

National Provider Directory

National Provider Directory
Tax ID family
Mercy Hospital Medical Cen6 organizations share this tax ID, including this one
Part of
Mercy Hospital Medical Cen

Other organizations with this tax ID 5

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": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1356517544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "address_2": "B-522",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162333",
            "telephone_number": "312-567-6691",
            "fax_number": "312-567-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S MICHIGAN AVE",
            "address_2": "B-522",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162333",
            "telephone_number": "312-567-6691",
            "fax_number": "312-567-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL & MEDICAL CENTER DASA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HOSPITAL & MEDICAL CENTER",
        "enumeration_date": "2008-05-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GARVEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP FINANCE CFO",
        "authorized_official_telephone_number": "312-567-2000"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "35",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE BL'G",
            "identifier": "14-0158",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 21, 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.