NPIMap

Organization Active NPI

Advocate Illinois Masonic

  • Student in an Organized Health Care Education/Training Program
  • Chicago, IL
National Provider Identifier
1376700732
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Legal business name
ADVOCATE ILLINOIS MASONIC
Practice address
836 W Wellington Ave
Family Practice
Chicago, IL 60657-5147
Phone
(773) 296-8250
NPI assigned
May 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Evelyn Cotto
Title
Residency Coordinator
Phone
(773) 296-8250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 390200000X Primary

Addresses

Primary practice location

836 W Wellington Ave
Family Practice
Chicago, IL 60657-5147

Mailing address

3430 N Elaine PL
Apt 4
Chicago, IL 60657-2483

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1376700732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 N ELAINE PL",
            "address_2": "APT 4",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606572483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "address_2": "FAMILY PRACTICE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "773-296-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCATE ILLINOIS MASONIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "COTTO",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_title_or_position": "RESIDENCY COORDINATOR",
        "authorized_official_telephone_number": "773-296-8250"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 21, 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.