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Organization Active NPI

Saint Anthony Hospital

  • Psychiatric Hospital Unit
  • Chicago, IL
National Provider Identifier
1518170877
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
0004556 Issued in IL
Legal business name
SAINT ANTHONY HOSPITAL
Practice address
2875 W 19TH St
Chicago, IL 60623-3501
Phone
(773) 484-4800
Fax
(773) 484-4806
NPI assigned
May 7, 2007
Organization subpart
Yes
Parent organization
SAINT ANTHONY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Authorized official

Name
Dennis O Anosike
Title
Cfo
Phone
(773) 484-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 0004556 IL Primary

Addresses

Primary practice location

2875 W 19TH St
Chicago, IL 60623-3501

Mailing address

1340 S Damen Ave
Chicago, IL 60608-1169
Phone (773) 484-1000

Other names 1

  • Psychiatric Department Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090609000486 IL Part A Provider - Hospital 2365541950 Practice locations: Chicago, IL

Hospital certification: CCN 14S095

Legal name
SAINT ANTHONY HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Nov 4, 1995 in IL
Enrollment address
2875 W 19TH St
Chicago, IL 60623-3501
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
St Joseph HLTH Ctr Hosp14 organizations share this tax ID, including this one
Part of
St Joseph HLTH Ctr Hosp

Other organizations with this tax ID 13

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

View all 13

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tyla Courtney Individual Corporate Director Jul 1, 2012
Wayne M Detmer Individual Corporate Director Apr 30, 2009
Dorval R Carter Individual Corporate Director Aug 1, 2009
Dennis O Anosike Individual Corporate OfficerCfo Dec 11, 2024
W-2 Managing EmployeeCfo Dec 11, 2024
Jaime Di Paulo Individual Corporate Director Aug 1, 2016
Richard Nelson Individual Corporate Director Aug 1, 2009
Frank W Zappa Individual Corporate Director Aug 1, 2009

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1518170877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081169",
            "telephone_number": "773-484-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 W 19TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233501",
            "telephone_number": "773-484-4800",
            "fax_number": "773-484-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT ANTHONY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAINT ANTHONY HOSPITAL",
        "enumeration_date": "2007-05-07",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "ANOSIKE",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "773-484-1000"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "IL",
            "license": "0004556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychiatric Department",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Psychiatric Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.