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Organization Active NPI

Shriners Hospitals for Children

  • Children's Hospital
  • Chicago, IL
National Provider Identifier
1376656538
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's HospitalTaxonomy code 282NC2000X
Legal business name
SHRINERS HOSPITALS FOR CHILDREN
Practice address
2211 N Oak Park Ave
Chicago, IL 60707-3351
Phone
(773) 622-5400
Fax
(773) 385-5453
NPI assigned
Aug 15, 2006
Organization subpart
No

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
Mr. Mark Niederpruem, FACHE
Title
Administrator
Phone
(773) 385-5445

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X
Children's Hospital 282NC2000X IL Primary

Addresses

Primary practice location

2211 N Oak Park Ave
Chicago, IL 60707-3351

Mailing address

PO Box 8500
Lockbox #7642
Philadelphia, PA 19178-7642
Phone (813) 218-8478

Other identifiers 3

IdentifierTypeStateIssuer
201076690AMedicaidIN
1376656538MedicaidIA
1376656538MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120713000486 IL Part A Provider - Hospital 9133031933 Practice locations: Chicago, IL

Hospital certification: CCN 143302

Legal name
SHRINERS HOSPITALS FOR CHILDREN
Certification status
Active
Provider type (POS)
Hospital – Children’s
Participating since
Mar 24, 2011
Last certification
Mar 24, 2011
Beds
60
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jun 18, 1925 in CO
Enrollment address
2211 N Oak Park Ave
Chicago, IL 60707-3351
Main/Primary Hospital Location
Hospital subgroups
Children’s

Care Compare: Hospital

Medicare Care Compare
Listed as
Shriners Hospital for ChildrenCCN 143302
Type
Childrens
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Shriners Hosp for Children49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

Locations

1310 Punahou St
Honolulu, HI 96826
Phone (808) 941-4466

55 Fruit St
Ste YAW3400
Boston, MA 02114

512 Carew St
Springfield, MA 01104

1 Childrens Plz
#2
Dayton, OH 45404
Phone (513) 872-6000

815 Market St
Galveston, TX 77550
Phone (409) 770-6600

Ownership & related parties

All disclosed owners & managing parties 25

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
William B. Rasner Individual Corporate DirectorTrustee Jul 7, 2022
Jim L Cain Individual Corporate Director Jul 15, 2010
Matthew Sturlaugson Individual Corporate OfficerSecretary Jul 3, 2025
Corporate Director Jul 12, 2020
Lawrence J Leib Individual Corporate Officer1St Vice President Jul 3, 2025
Corporate Director Jul 7, 2018
Dale R. Vrsalovich Individual Corporate DirectorDirector Jul 4, 2024
Martin L. Bartlett Individual Corporate OfficerAssistant Secretary Jul 3, 2025
Corporate Director Jul 12, 2020
John P McCabe Individual W-2 Managing EmployeeExecutive Vice President Jul 15, 2010
Ronald Capps Individual Corporate DirectorTrustee Jul 4, 2024
Phillip L Grady Individual W-2 Managing EmployeeVice President Hospital Operations Jul 15, 2018
Lee Anne Eddy Individual W-2 Managing EmployeeDirector of Patient Care Services Jan 9, 2023
Mathew Lucas Individual W-2 Managing EmployeeDirector Fiscal Services Nov 28, 2022
Dennis W. Hewatt Individual Corporate DirectorTrustee Jul 3, 2025
David C. Hamm Individual Corporate Director Jul 6, 2023
Scott Allen Schuster Individual Corporate OfficerTreasurer Jul 3, 2025
Corporate Director Jul 3, 2025
Timothy L. Ludwig Individual Corporate DirectorTrustee Jul 6, 2023
Ricky Holloway Individual Corporate Director Jul 3, 2025
Mark E Hartz Individual Corporate Officer2ND Vice President Jul 3, 2025
Corporate Director Jul 7, 2018
Leslie D Stewart Individual Corporate OfficerPresident Jul 4, 2024
Corporate Director Jul 12, 2020
Timothy D Forbis Individual Corporate Director Jul 8, 2021
Brad T Koehn Individual Corporate OfficerChairman, Board of Directors Jul 3, 2025
Corporate Director Jul 7, 2018
Kenneth G Craven Individual Corporate DirectorTrustee Jul 10, 2014
Ronald Devoll Individual Corporate Director Jul 7, 2022
Shriners Hospitals for Children Organization, Tampa, FL Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Operational/Managerial Control Jan 1, 1966 100%
Craig D McGhee Individual W-2 Managing EmployeeAdministrator Sep 6, 2022
Richard G Burke Individual Corporate Director Jul 5, 2016

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Shriners Hospitals for ChildrenPhiladelphia, PA, CCN 393309 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 24, 1966
Jun 24, 1966
Shriners Hospitals for ChildrenPortland, OR, CCN 383300 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 15, 1966
Jan 15, 2015
Shriners Hospitals for ChildrenGalveston, TX, CCN 453311 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 20, 1966
Mar 20, 1966
Shriners Hospitals for ChildrenHonolulu, HI, CCN 123301 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2013
Oct 1, 2013
Shriners Hospitals for ChildrenSacramento, CA, CCN 053311 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Apr 15, 1997
Apr 15, 1997
Shriners Hospitals for ChildrenGreenville, SC, CCN 423300 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Aug 20, 2013
Jul 15, 2010
Shriners Children'S OhioDayton, OH, CCN 363308 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 19, 1968
Feb 19, 1968
Shriners Hospitals for ChildrenSaint Louis, MO, CCN 263304 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1966
Jan 1, 1966

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1376656538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500",
            "address_2": "LOCKBOX #7642",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191787642",
            "telephone_number": "813-218-8478",
            "fax_number": "813-281-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 N OAK PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607073351",
            "telephone_number": "773-622-5400",
            "fax_number": "773-385-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHRINERS HOSPITALS FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NIEDERPRUEM",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "773-385-5445",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FACHE"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201076690A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376656538",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376656538",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.