NPIMap

Organization Active NPI

Swedish Covenant Management Services, Inc.

Doing business as Comprehensive Wellness Care

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1407002108
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036-086740 Issued in IL
Legal business name
SWEDISH COVENANT MANAGEMENT SERVICES, INC.
Doing business as
Comprehensive Wellness Care
Practice address
2825 N Halsted St
1St Floor
Chicago, IL 60657-5105
Phone
(773) 549-8900
Fax
(773) 549-8511
NPI assigned
Aug 13, 2008
Last updated
Aug 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Authorized official

Name
Gary Krugel
Title
Senior Vice President,Operation/Cfo
Phone
(773) 878-8200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 036117858 IL
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 036-086740 IL Primary

Addresses

Primary practice location

2825 N Halsted St
1St Floor
Chicago, IL 60657-5105

Mailing address

5019 N Mozart St
Attn: Soultana Amaxopoulos
Chicago, IL 60625-3615
Phone (773) 293-3223

Other names 1

  • COMPREHENSIVE WELLNESS CARE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040123000850 IL Part B Supplier - Clinic/Group Practice 4486556016 Receives reassigned benefits from 381 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chicago, IL; Elmhurst, IL; Evanston, IL; Hoffman Estates, IL; Buffalo Grove, IL

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

5019 N Mozart St
Chicago, IL 60625

1200 S York St
Ste 4240
Elmhurst, IL 60126
Phone (630) 834-7590

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1407002108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5019 N MOZART ST",
            "address_2": "ATTN: SOULTANA AMAXOPOULOS",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253615",
            "telephone_number": "773-293-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 N HALSTED ST",
            "address_2": "1ST FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575105",
            "telephone_number": "773-549-8900",
            "fax_number": "773-549-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEDISH COVENANT MANAGEMENT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "KRUGEL",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT,OPERATION/CFO",
        "authorized_official_telephone_number": "773-878-8200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036117858",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-086740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMPREHENSIVE WELLNESS CARE",
            "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 Aug 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.