NPIMap

Organization Active NPI

Mercy Dunbar Health Center

  • Student Health Clinic/Center
  • Chicago, IL
National Provider Identifier
1457582975
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
License
0001578 Issued in IL
Legal business name
MERCY DUNBAR HEALTH CENTER
Practice address
3000 S King Dr
Chicago, IL 60616-3452
Phone
(312) 567-7058
Fax
(312) 328-7982
NPI assigned
Jul 31, 2009
Organization subpart
Yes
Parent organization
MERCY HOSPITAL & MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Authorized official

Name
Mrs. Patrice Kathleen Griffin
Title
Delegated Official
Phone
(312) 567-5593

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X 0001578 IL Primary
Clinical Medical Laboratory 291U00000X 771115009 IL

Addresses

Primary practice location

3000 S King Dr
Chicago, IL 60616-3452

Mailing address

3000 S King Dr
Chicago, IL 60616-3452
Phone (312) 567-7058

Other identifiers 2

IdentifierTypeStateIssuer
771115009OtherILDHS
14D0951881OtherILCLIA

National Provider Directory

National Provider Directory
Tax ID family
Mercy Hospital Medical Cen6 organizations share this tax ID, including this one
Part of
Mercy Hospital Medical Cen

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1457582975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 S KING DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163452",
            "telephone_number": "312-567-7058",
            "fax_number": "312-328-7982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 S KING DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163452",
            "telephone_number": "312-567-7058",
            "fax_number": "312-328-7982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY DUNBAR HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HOSPITAL & MEDICAL CENTER",
        "enumeration_date": "2009-07-31",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "312-567-5593",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "IL",
            "license": "0001578",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": "771115009",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHS",
            "identifier": "771115009",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "14D0951881",
            "state": "IL"
        }
    ],
    "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 Mar 29, 2018; 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.