NPIMap

Organization Active NPI

Presence Chicago Hospitals Network

Doing business as AMITA Health Outpatient Pharmacy - Saint Joseph Hospital Chicago

  • Community/Retail Pharmacy
  • Chicago, IL
National Provider Identifier
1538741491
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PRESENCE CHICAGO HOSPITALS NETWORK
Doing business as
AMITA Health Outpatient Pharmacy - Saint Joseph Hospital Chicago
Practice address
331 W Surf St Ste 101
Chicago, IL 60657-7227
Phone
(773) 665-3871
NPI assigned
Apr 21, 2021
Last updated
Apr 21, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
PRESENCE CHICAGO HOSPITALS NETWORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Authorized official

Name
Lisa E Neuman
Title
Vice President
Phone
(224) 273-0516

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

331 W Surf St Ste 101
Chicago, IL 60657-7227

Mailing address

331 W Surf St Ste 101
Chicago, IL 60657-7227
Phone (773) 665-3871

Other names 1

  • AMITA Health Outpatient Pharmacy - Saint Joseph Hospital Chicago Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211022002467 IL Part B Supplier - Pharmacy 2062313000 Practice locations: Chicago, IL

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
Presence Resurrection Osi8 organizations share this tax ID, including this one
Part of
Presence Resurrection Osi

Other organizations with this tax ID 7

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

Locations

200 S Wacker Dr
Fl 12
Chicago, IL 60606

4588 Collection Paysphere
Chicago, IL 60674

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
NazarethvilleDes Plaines, IL, CCN 146180 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2012

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1538741491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 W SURF ST STE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577227",
            "telephone_number": "773-665-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 W SURF ST STE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577227",
            "telephone_number": "773-665-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE CHICAGO HOSPITALS NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESENCE CHICAGO HOSPITALS NETWORK",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "NEUMAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "224-273-0516"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMITA Health Outpatient Pharmacy - Saint Joseph Hospital Chicago",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.