NPIMap

Organization Active NPI

St Bernard Hospital & Health Care Center

Doing business as Center for Better Aging Services

  • Geriatric Medicine (Family Medicine) Physician
  • Chicago, IL
National Provider Identifier
1700635190
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
ST BERNARD HOSPITAL & HEALTH CARE CENTER
Doing business as
Center for Better Aging Services
Practice address
6307 S Stewart Ave
Chicago, IL 60621-3116
Phone
(773) 420-1573
Fax
(773) 420-1851
NPI assigned
May 16, 2024
Last updated
May 16, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ST BERNARD HOSPITAL & HEALTH CARE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 16, 2024

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
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X Primary

Addresses

Primary practice location

6307 S Stewart Ave
Chicago, IL 60621-3116

Mailing address

326 W 64TH St
Chicago, IL 60621-3114
Phone (773) 962-3900

Other names 1

  • Center for Better Aging Services 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
Part of
St Bernard Emerg Physic

Other organizations with this tax ID 12

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

Practitioners & affiliated clinicians

Practitioners 73

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 73

NPI Registry JSON

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1700635190",
    "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": "773-962-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6307 S STEWART AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213116",
            "telephone_number": "773-420-1573",
            "fax_number": "773-420-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST BERNARD HOSPITAL & HEALTH CARE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST BERNARD HOSPITAL & HEALTH CARE CENTER",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "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": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Better Aging Services",
            "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 May 16, 2024; 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.