NPIMap

Organization Active NPI

Swedish Covenant Hospital

Doing business as Roosevelt High School Clinic

  • Student Health Clinic/Center
  • Chicago, IL
National Provider Identifier
1740408186
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
SWEDISH COVENANT HOSPITAL
Doing business as
Roosevelt High School Clinic
Practice address
3436 W Wilson Ave
Chicago, IL 60625-5318
Phone
(773) 534-5000
NPI assigned
Apr 23, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Selma Kulenovic
Title
Director of Finance & Business Plan
Phone
(773) 878-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X NU Primary

Addresses

Primary practice location

3436 W Wilson Ave
Chicago, IL 60625-5318

Mailing address

5140 N California Ave
Suite 635-645
Chicago, IL 60625-3645
Phone (773) 293-3223

Other names 1

  • ROOSEVELT HIGH SCHOOL CLINIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Swedish Vocenant Hospit9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

3436 W Wilson Ave
Chicago, IL 60625
Phone (773) 866-0818

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740408186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 N CALIFORNIA AVE",
            "address_2": "SUITE 635-645",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253645",
            "telephone_number": "773-293-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3436 W WILSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606255318",
            "telephone_number": "773-534-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEDISH COVENANT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KULENOVIC",
        "authorized_official_first_name": "SELMA",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE & BUSINESS PLAN",
        "authorized_official_telephone_number": "773-878-8200"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROOSEVELT HIGH SCHOOL CLINIC",
            "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 Aug 22, 2020; 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.