NPIMap

Organization Active NPI

Advocate Illinois Masonic Hospital

  • General Acute Care Hospital
  • Chicago, IL
National Provider Identifier
1407154156
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
164005250 Issued in IL
Legal business name
ADVOCATE ILLINOIS MASONIC HOSPITAL
Practice address
836 W Wellington Ave
Chicago, IL 60657-5147
Phone
(773) 975-1600
NPI assigned
Mar 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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

Authorized official

Name
Jaclyn Sprague, RD
Title
Manager Nutrition Services
Phone
(773) 296-5194

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 164005250 IL Primary

Addresses

Primary practice location

836 W Wellington Ave
Chicago, IL 60657-5147

Mailing address

836 W Wellington Ave
Chicago, IL 60657-5147
Phone (773) 975-1600

Other names 1

  • Private - Self - employeed Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1299196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299196800000",
    "number": "1407154156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "773-975-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "773-975-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCATE ILLINOIS MASONIC HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-04",
        "last_updated": "2011-03-04",
        "status": "A",
        "authorized_official_last_name": "SPRAGUE",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "MANAGER NUTRITION SERVICES",
        "authorized_official_telephone_number": "773-296-5194",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "164005250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Private - Self - employeed",
            "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 Mar 4, 2011; 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.