NPIMap

Organization Active NPI

American Hospital Service Corporation

  • Primary Care Clinic/Center
  • Chicago, IL
National Provider Identifier
1710296603
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
036058369 Issued in IL
Legal business name
AMERICAN HOSPITAL SERVICE CORPORATION
Practice address
6157 W Belmont Ave
Chicago, IL 60634-4004
Phone
(773) 745-8434
Fax
(773) 745-3443
NPI assigned
Sep 27, 2010
Last updated
Oct 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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

Authorized official

Name
Dr. Henryk J Roztoczynski, MD, PHDNPI 1457430415
Title
President
Phone
(773) 745-8434

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 036058369 IL Primary

Addresses

Primary practice location

6157 W Belmont Ave
Chicago, IL 60634-4004

Mailing address

6157 W Belmont Ave
Chicago, IL 60634-4004
Phone (773) 745-8434

Other identifiers 4

IdentifierTypeStateIssuer
31600059OtherILBCBS
AR8609236OtherILFDA
036058369MedicaidIL
14D0878232OtherILCLIA

National Provider Directory

National Provider Directory

Locations

6157 W Belmont Ave
Chicago, IL 60634
Phone (773) 745-8434

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445385600000",
    "number": "1710296603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6157 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344004",
            "telephone_number": "773-745-8434",
            "fax_number": "773-745-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6157 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344004",
            "telephone_number": "773-745-8434",
            "fax_number": "773-745-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN HOSPITAL SERVICE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-27",
        "last_updated": "2015-10-21",
        "status": "A",
        "authorized_official_last_name": "ROZTOCZYNSKI",
        "authorized_official_first_name": "HENRYK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-745-8434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036058369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "31600059",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FDA",
            "identifier": "AR8609236",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058369",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "14D0878232",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 21, 2015; 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.