Active NPI
Advocate Condell Medical Center
Doing business as Advocate Condell Medical Center Grays Lake
- Mobile Mammography Clinic/Center
- Grayslake, IL
National Provider Identifier
1770737199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mobile Mammography Clinic/Center
- License
- 0000422
- Legal business name
- ADVOCATE CONDELL MEDICAL CENTER
- Doing business as
- Advocate Condell Medical Center Grays Lake
- Practice address
- 1170 E Belvidere Rd
Grayslake, IL 60030-2061 - Phone
- (847) 223-0127
- NPI assigned
- Nov 12, 2008
- Last updated
- Dec 10, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. David Cartwright
- Title
- Vice President of Finance/Cfo
- Phone
- (847) 990-5205
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mobile Mammography Clinic/Center | 261QR0207X | 0000422 | IL | Primary |
| General Acute Care Hospital | 282N00000X | 0000422 | IL |
Addresses
Primary practice location
1170 E Belvidere Rd
Grayslake, IL 60030-2061
Mailing address
900 Garfield Ave
Libertyville, IL 60048-3141
Phone (847) 362-2905
Other names 1
- Advocate Condell Medical Center Grays Lake
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090122000249 | IL | Part A Provider - Hospital | 9133283013 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Gurnee, IL; Grayslake, IL; Vernon Hills, IL; Round Lake Beach, IL; Lincolnshire, IL; Libertyville, IL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1770737199. Details of each certification follow.
Hospital certification: CCN 140202
- Legal name
- ADVOCATE CONDELL MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Dec 12, 2019
- Beds
- 284
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation
- Enrollment address
- 801 S Milwaukee Ave
Libertyville, IL 60048-3204 - Hospital subgroups
- General, Acute care
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Advocate Condell Imaging Center
- Mobile Mammography Clinic/Center
- Gurnee, IL
- NPI 1023262441
O20090122000249
-
- General Acute Care Hospital
- Libertyville, IL
- NPI 1124272547
O20090122000249
Care Compare: Hospital
Medicare Care Compare- Listed as
- Advocate Condell Medical Center
- Overall star rating
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 19
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Dia Nichols | Corporate Officer | Oct 1, 2024 | |
| Corporate Director | Oct 1, 2024 | ||
| Advocate Health Care Network | 5% Or Greater Indirect Ownership Interest | Dec 1, 2008 | 100% |
| Gail D Hasbrouck | Corporate Director | Jan 8, 2018 | |
| Clarence Nixon | Corporate Officer | Jan 1, 2025 | |
| Corporate Director | Oct 1, 2005 | ||
| Tori Munnik | Corporate Officer | Jun 3, 2026 | |
| Rachelle Hart | Corporate Officer | Jun 14, 2023 | |
| Kara Richardson | Corporate Officer | Oct 1, 2024 | |
| David B Anderson | Corporate Director | Oct 1, 2008 | |
| Iliana Mora | W-2 Managing Employee | Nov 3, 2025 | |
| Lindsay Durgin | Corporate Officer | Jul 1, 2025 | |
| Rachel Halverson | Corporate Officer | Jun 14, 2023 | |
| Desiree Millet | Corporate Officer | Jun 3, 2026 | |
| Nathaniel L Edmond | Corporate Officer | Jan 1, 2025 | |
| Corporate Director | Jun 1, 2013 | ||
| Harold James Jr Slinkman | Corporate Officer | Jun 14, 2023 | |
| Advocate Health and Hospitals Corporation | 5% Or Greater Direct Ownership Interest | Dec 1, 2008 | 100% |
| Advocate Health Inc | Operational/Managerial Control | Dec 2, 2022 | |
| Mark M Harris | Corporate Director | Oct 1, 2005 | |
| Advocate Aurora Health, Inc. | 5% Or Greater Indirect Ownership Interest | Apr 1, 2018 | 100% |
| Operational/Managerial Control | Apr 1, 2018 | 100% | |
| Kathie S Bender Schwich | Corporate Director | Jun 11, 2023 |
Practitioners & affiliated clinicians
Affiliated clinicians 848
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Interventional Cardiology Physician
- Barrington, IL
- NPI 1891185609
Hospital
-
- Anatomic Pathology & Clinical Pathology Physician
- Chicago, IL
- NPI 1932151966
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226448000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1291939200000",
"number": "1770737199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 GARFIELD AVE",
"city": "LIBERTYVILLE",
"state": "IL",
"postal_code": "600483141",
"telephone_number": "847-362-2905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1170 E BELVIDERE RD",
"city": "GRAYSLAKE",
"state": "IL",
"postal_code": "600302061",
"telephone_number": "847-223-0127"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVOCATE CONDELL MEDICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2008-11-12",
"last_updated": "2010-12-10",
"status": "A",
"authorized_official_last_name": "CARTWRIGHT",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE/CFO",
"authorized_official_telephone_number": "847-990-5205",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QR0207X",
"taxonomy_group": "",
"desc": "Clinic/Center, Radiology, Mobile Mammography",
"state": "IL",
"license": "0000422",
"primary": true
},
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "IL",
"license": "0000422",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Advocate Condell Medical Center Grays Lake",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Grayslake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.