NPIMap

Organization Active NPI

Jackson Park Hospital

  • General Acute Care Hospital
  • Chicago, IL
National Provider Identifier
1740567312
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
125.060628 Issued in IL
Legal business name
JACKSON PARK HOSPITAL
Practice address
1625 E 75TH St
1St Floor
Chicago, IL 60649-3603
Phone
(773) 947-7500
NPI assigned
Nov 10, 2011
Last updated
Jan 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Authorized official

Name
Ruksana Nazneen, MDNPI 1063432474
Title
Program Director
Phone
(773) 947-7500

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
General Acute Care Hospital 282N00000X 125.060628 IL Primary

Addresses

Primary practice location

1625 E 75TH St
1St Floor
Chicago, IL 60649-3603

Mailing address

1625 E 75TH St
1St Floor
Chicago, IL 60649-3603
Phone (773) 947-7500

National Provider Directory

National Provider Directory
Tax ID family
Jackson Park Hosp Ultra2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1625 E 75th St
Fl 1
Chicago, IL 60649
Phone (630) 656-4069

Practitioners & affiliated clinicians

Practitioners 4

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": "1320883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1740567312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 E 75TH ST",
            "address_2": "1ST FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493603",
            "telephone_number": "773-947-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 E 75TH ST",
            "address_2": "1ST FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493603",
            "telephone_number": "773-947-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PARK HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-10",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "NAZNEEN",
        "authorized_official_first_name": "RUKSANA",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "773-947-7500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "125.060628",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 28, 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.