NPIMap

Organization Active NPI

St Bernard Hospital

Doing business as SBH Radiology Group

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1649838004
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ST BERNARD HOSPITAL
Doing business as
SBH Radiology Group
Practice address
326 W 64TH St
Chicago, IL 60621-3114
Phone
(773) 962-3900
Fax
(773) 962-4480
NPI assigned
May 31, 2019
Last updated
Nov 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Authorized official

Name
Robert C Springer
Title
Cfo
Phone
(773) 962-4210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

326 W 64TH St
Chicago, IL 60621-3114

Mailing address

326 W 64TH St
Chicago, IL 60621-3114
Phone (773) 962-4210

Other names 1

  • SBH Radiology Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040722000725 IL Part B Supplier - Clinic/Group Practice 1759361579 Receives reassigned benefits from 77 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chicago, IL

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
St Bernard Emerg Physic13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1649838004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 W 64TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213114",
            "telephone_number": "773-962-4210",
            "fax_number": "773-962-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 W 64TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213114",
            "telephone_number": "773-962-3900",
            "fax_number": "773-962-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST BERNARD HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-31",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "SPRINGER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "773-962-4210"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SBH Radiology Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SBH Radiology Group",
            "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 23, 2020; 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.