Jesse Brown Veterans Administration Hospital

Primary specialty

Critical Access HospitalTaxonomy code 282NC0060X

License

036066117 Issued in IL

Legal business name

JESSE BROWN VETERANS ADMINISTRATION HOSPITAL

Practice address

820 S Damen Ave
Chicago, IL 60612-3728

Phone

(312) 569-6123

Fax

(312) 569-8102

NPI assigned

Oct 9, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Farida Ahmed, M.D.

Title

Staff Radiologist

Phone

(312) 569-6123

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1128816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216598400000",
    "number": "1679561260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N CLARK ST",
            "address_2": "UNIT K.,",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606108701",
            "telephone_number": "312-280-1840",
            "fax_number": "312-280-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123728",
            "telephone_number": "312-569-6123",
            "fax_number": "312-569-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSE BROWN VETERANS ADMINISTRATION HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-09",
        "last_updated": "2008-07-21",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "FARIDA",
        "authorized_official_title_or_position": "STAFF RADIOLOGIST",
        "authorized_official_telephone_number": "312-569-6123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IL",
            "license": "036066117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Brown VA Medical Center
• Jesse Brown VA Medical Center
• Jesse Brown VA Medical Center
• Jesse Brown VA Medical Center
• Jesse Brown Veterans Administration
• Jesse S Chandler MD SC (Chatham Obstetrics & Gynecology Assoc)
• Ellen Jesse, M.S., CCC-SLP
• John Nicholas Jesse III, M.D.
• Kevin M. Jesse, LCSW
• Ashley Jessen

• Critical Access Hospital in Chicago, IL
• Providers in Chicago, IL by specialty
• Critical Access Hospital in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; 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.