NPIMap

Organization Active NPI

Jackson Park Hospital Foundation

  • Psychiatric Hospital Unit
  • Chicago, IL
National Provider Identifier
1396250304
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
0001115 Issued in IL
Legal business name
JACKSON PARK HOSPITAL FOUNDATION
Practice address
7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone
(773) 947-7500
NPI assigned
Dec 13, 2017
Last updated
Jan 28, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
JACKSON PARK HOSPITAL FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Authorized official

Name
Mr. Barry R Mandell
Title
VP of Special Projects
Phone
(773) 947-7701

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 0001115 IL Primary

Addresses

Primary practice location

7531 S Stony Island Ave
Chicago, IL 60649-3954

Mailing address

7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone (773) 947-7500

Other names 1

  • Psychiatric Unit Other name

National Provider Directory

National Provider Directory
Part of
Jackson Park Hosp Ultra

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1396250304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7531 S STONY ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493954",
            "telephone_number": "773-947-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7531 S STONY ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493954",
            "telephone_number": "773-947-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PARK HOSPITAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACKSON PARK HOSPITAL FOUNDATION",
        "enumeration_date": "2017-12-13",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "MANDELL",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VP OF SPECIAL PROJECTS",
        "authorized_official_telephone_number": "773-947-7701",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "IL",
            "license": "0001115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychiatric Unit",
            "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 Jan 28, 2020; 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.