St. Bernard Hospital
Organization Active NPI General Acute Care Hospital · Chicago, IL
NPI 1811034291 · NPPES record last updated Sep 10, 2010
Key facts
- NPI
- 1811034291
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- License
- 0002303 (IL)
- Legal business name
- ST. BERNARD HOSPITAL
- Practice address
- 326 W 64TH St
Chicago, IL 60621-3114 - Phone
- (773) 962-4100
- Fax
- (773) 962-9276
- NPI assigned
- Feb 1, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Guy Richard Alton, CPA
- Title
- Chief Financial Officer
- Phone
- (773) 962-4073
Owners & managing parties with NPI records 5
-
George Dengler, DO
-
Raj Khurana, M.D.
-
Olalekan Sowade, M.D.
-
Daria B Terrell, MD
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 12
Member organizations 2
Practitioners 43
-
Rizwan Ahmed, D.O
-
Ayoade O. Akere, MD
-
Marsha A Apushkin, M.D.
-
Brennan Barrett, D.O.
-
Hashem Beik, MD
-
Meghan Elizabeth Busky, MS, RDN
-
Pamela A. Clanton, CRNA
-
Taral Doshi, M.D.
-
Steve Fankam, CRNA
-
Jennifer A Gardner, CRNA
-
Albert Gjeluci, MD
-
Sherine Hanna, MD
-
Frank William Hsu, M.D.
-
Timothy William Kane, CRNA
-
Mohammed Mohsin Khadir, M.D.
-
Raj Khurana, M.D.
-
Wendy Liu, M.D.
-
Marijan Pejic, MD
-
Melissa M. Penas, M.D.
-
Dante Anthony Pimentel, M.D.
Affiliated clinicians 119
-
Olufemi Aboyeji, MD
-
Rizwan Ahmed, D.O
-
Ayoade O. Akere, MD
-
Saarah Alkhairy, MD, MBA
-
Bimbola Mufliat Amoranbini, PMHNP
-
Marsha A Apushkin, M.D.
-
Deepak Ariga, MD
-
Wadah Atassi, MD
-
Stephanie Atoyebi, DPM
-
Teia L Atwood, NP-C
-
Shakira Ayanlaja, APN
-
Dustin Barfield, MD
-
Katrina Lee Basic, FNP-C, EMT-P
-
Hashem Beik, MD
-
Alemayehu Bekele, MD
-
Wyvon Blackwell, MSN, APRN,FNP-C
-
Winston Franklin Burke, D.P.M.
-
Meghan Elizabeth Busky, MS, RDN
-
David N Butler, M.D.
-
Jeffrey Bzdusek, DO
-
Benjamin Calayag, MD
Medicare Care Compare: Hospital
- Listed as
- St Bernard Hospital
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Church
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Hospital certification: CCN 140103
- Legal name
- ST BERNARD HOSPITAL
- Doing business as
- ST. BERNARD HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Feb 2, 2022
- Beds
- 210
- Ownership / control type
- Church
- Organization structure
- Corporation · Non-profit
- Incorporated
- Apr 27, 1904 in IL
- Enrollment address
- 326 W 64TH St
Chicago, IL 60621-3114 - Hospital subgroups
- Acute care
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Charles a Holland |
Corporate Officer |
Jan 2, 2013 | |
| Operational/Managerial Control |
Jan 2, 2013 | 100% | |
| George S Dengler |
Corporate Director |
Mar 1, 2018 | |
| St Bernard Hospital |
5% Or Greater Direct Ownership Interest | Jul 14, 2010 | 100% |
| Olalekan O Sowade |
Corporate Officer |
Mar 1, 2019 | |
| Mary Pokorny |
Corporate Officer |
Mar 1, 2021 | |
| Gerald Dew |
Corporate Director |
Mar 1, 2021 | |
| Elizabeth Vanstraten |
Corporate Director |
Jan 1, 2010 | |
| Joanne Delehanty |
Corporate Director |
Jan 1, 2010 | |
| Patricia Merryweather-Arges |
Corporate Officer |
Mar 1, 2021 | |
| Carol Collum |
Corporate Director |
Mar 1, 2021 | |
| Daria B Terrell |
Corporate Director |
Mar 1, 2022 | |
| Felicia Slaton-Young |
Corporate Director |
Mar 1, 2021 | |
| Michael Cleavenger |
Corporate Director |
Mar 1, 2017 | |
| Raj Kumar Khurana |
Corporate Director |
Mar 1, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100811000087 | IL | Part a Provider - Hospital | 1759361579 | Practice locations: Chicago, IL |
National Provider Directory
- Tax ID family
- St Bernard Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 0002303 | IL | Yes |
Addresses
Primary practice location
326 W 64TH St
Chicago, IL 60621-3114
Mailing address
326 W 64TH St
Chicago, IL 60621-3114
Phone (773) 962-4100
Other providers in Chicago, IL
- St Thomas Health Care Inc
- Joelle St-Pierre
- St. Anthony'S Spine & Joint Institute, P.C.
- St. Bernard Hospital
- St. Bernard Hospital
- St. Bernard Hospital Ambulatory Care Center Pharmacy
- St. Bernard Hospital Ambulatory Care Clinic
- Kayla Myra St. Claire
- Melanie Lynn St. Fleur
- St. Joseph Hospital
All providers in Chicago, IL · General Acute Care Hospital in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.