NPIMap

Organization Active NPI

Sidney Hillman Health Centre of the Chicago and Cent St JNT BRD Union

  • Multi-Specialty Clinic/Center
  • Chicago, IL
National Provider Identifier
1649324211
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SIDNEY HILLMAN HEALTH CENTRE OF THE CHICAGO AND CENT ST JNT BRD UNION
Practice address
333 S Ashland Ave
Fourth and Fifth Floor
Chicago, IL 60607-2703
Phone
(312) 738-6170
Fax
(312) 942-1554
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Authorized official

Name
Adriana Medina
Title
Executive Director
Phone
(312) 738-6196

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

333 S Ashland Ave
Fourth and Fifth Floor
Chicago, IL 60607-2703

Mailing address

333 S Ashland Ave
Fourth and Fifth Floor
Chicago, IL 60607-2703
Phone (312) 738-6170

Other identifiers 1

IdentifierTypeStateIssuer
1649324211OtherNPI

Other names 1

  • Sidney Hillman Health Centre Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101119000327 IL Part B Supplier - Clinic/Group Practice 5294798666 Receives reassigned benefits from 9 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

333 S Ashland Ave
Fl Fifth
Chicago, IL 60607
Phone (312) 738-6170

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636070400000",
    "number": "1649324211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S ASHLAND AVE",
            "address_2": "FOURTH AND FIFTH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072703",
            "telephone_number": "312-738-6170",
            "fax_number": "312-942-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S ASHLAND AVE",
            "address_2": "FOURTH AND FIFTH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072703",
            "telephone_number": "312-738-6170",
            "fax_number": "312-942-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIDNEY HILLMAN HEALTH CENTRE OF THE CHICAGO AND CENT ST JNT BRD UNION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-04",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "ADRIANA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "312-738-6196"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1649324211",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sidney Hillman Health Centre",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sidney Hillman Health Centre",
            "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 Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.