CHS Illinois Medical, S.C.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

CHS ILLINOIS MEDICAL, S.C.

Doing business as

Altria Health Center

Practice address

11601 Copenhagen CT
Franklin Park, IL 60131-1301

Phone

(847) 957-2847

NPI assigned

Oct 16, 2012

Last updated

Feb 4, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

CHS HEALTH SERVICES, LLCAs reported in NPPES

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

Authorized official

Name

Stuart Clark

Title

Executive VP

Phone

(615) 577-4927

Specialties & licenses 1

Addresses

Other names 1

• Altria Health Center Doing business as

Part of

Choose Health Wellness Ctr

Locations

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423008000000",
    "number": "1578816534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "address_2": "STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 COPENHAGEN CT",
            "city": "FRANKLIN PARK",
            "state": "IL",
            "postal_code": "601311301",
            "telephone_number": "847-957-2847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHS ILLINOIS MEDICAL, S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHS HEALTH SERVICES, LLC",
        "enumeration_date": "2012-10-16",
        "last_updated": "2015-02-04",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "EXECUTIVE VP",
        "authorized_official_telephone_number": "615-577-4927"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Altria Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Cook Cnty BD Education 083 (Leyden Area Spec Edu Coop)

• General Practice Physician in Franklin Park, IL
• Providers in Franklin Park, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; 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.