NPIMap

Organization Active NPI

Mercy Family Health Center @ Lower West Clinic

  • General Acute Care Hospital
  • Chicago, IL
National Provider Identifier
1700136124
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
2065063 Issued in IL
Legal business name
MERCY FAMILY HEALTH CENTER @ LOWER WEST CLINIC
Practice address
1713 S. Ashland Avenue
Chicago, IL 60608
Phone
(312) 746-5158
NPI assigned
Sep 13, 2012
Organization subpart
Yes
Parent organization
MERCY FAMILY HEALTH CENTER FQHC SITEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Authorized official

Name
Mr. Thomas J Garvey
Title
VP/Chief Financial Officer
Phone
(312) 567-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 2065063 IL Primary

Addresses

Primary practice location

1713 S. Ashland Avenue
Chicago, IL 60608

Mailing address

2525 S. Michigan Avenue
Chicago, IL 60616-2477
Phone (312) 567-7616

Other identifiers 1

IdentifierTypeStateIssuer
1619918497OtherILNPI

Other names 1

  • Mercy Diagnostic & Treatment Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Mercy Diagnostic and Treatment Center3 organizations share this tax ID, including this one
Part of
Mercy Diagnostic and Treatment Center

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1700136124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 S. MICHIGAN AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162477",
            "telephone_number": "312-567-7616",
            "fax_number": "312-328-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 S. ASHLAND AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60608",
            "telephone_number": "312-746-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY FAMILY HEALTH CENTER @ LOWER WEST CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY FAMILY HEALTH CENTER FQHC SITE",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "GARVEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP/CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "312-567-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "2065063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1619918497",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Diagnostic & Treatment Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Sep 13, 2012; 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.