Active NPI
Holy Cross Hospital
- Substance Abuse Rehabilitation Facility
- Chicago, IL
National Provider Identifier
1821840828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Abuse Rehabilitation Facility
- Legal business name
- HOLY CROSS HOSPITAL
- Practice address
- 2701 W 68TH St
Chicago, IL 60629-1882 - Phone
- (773) 884-9000
- NPI assigned
- Apr 3, 2024
- Last updated
- Apr 3, 2024
- 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
- Dimas Ortega
- Title
- VP Finance
- Phone
- (737) 257-2937
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | Primary |
Addresses
Primary practice location
2701 W 68TH St
Chicago, IL 60629-1882
Mailing address
PO Box 2166
Bedford Park, IL 60499-2166
Phone (773) 884-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071121000030 | IL | Part A Provider - Hospital | 3274518832 |
3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Chicago, IL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1821840828. Details of each certification follow.
Hospital certification: CCN 140133
- Legal name
- HOLY CROSS HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Sep 11, 2020
- Beds
- 311
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation
- Incorporated
- Oct 10, 1929 in IL
- Enrollment address
- 2701W 68TH St
Chicago, IL 60629-1882 - Hospital subgroups
- General, Acute care, Rehabilitation unit
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Substance Abuse Rehabilitation Facility
- Chicago, IL
- NPI 1770335770
O20071121000030
Care Compare: Hospital
Medicare Care Compare- Listed as
- Holy Cross Hospital
- Overall star rating
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
National Provider Directory
National Provider Directory- Tax ID family
- Geoffrey Sebastian MD
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Chicago, IL
- NPI 1629472451
-
- Substance Abuse Rehabilitation Facility
- Chicago, IL
- NPI 1770335770
-
dba Behavioral Health and Under The Rainbow at Holy Cross
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Chicago, IL
- NPI 1427410554
Ownership & related parties
All disclosed owners & managing parties 6
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 |
|---|---|---|---|
| Abraham C Morgan | Corporate Director | Jan 16, 2013 | |
| Bret R Maxwell | Corporate Director | Jan 15, 2013 | |
| Anne Donnelly Cohn | Corporate Director | Apr 10, 2013 | |
| Christopher Stephens | W-2 Managing Employee | Mar 15, 2015 | |
| Sinai Health System | Operational/Managerial Control | Jan 16, 2013 | 100% |
| Dimas Ortega | Corporate Officer | Dec 1, 2023 |
Practitioners & affiliated clinicians
Affiliated clinicians 187
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712102400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1712102400000",
"number": "1821840828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2166",
"city": "BEDFORD PARK",
"state": "IL",
"postal_code": "604992166",
"telephone_number": "773-884-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 W 68TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606291882",
"telephone_number": "773-884-9000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLY CROSS HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2024-04-03",
"last_updated": "2024-04-03",
"certification_date": "2024-04-03",
"status": "A",
"authorized_official_last_name": "ORTEGA",
"authorized_official_first_name": "DIMAS",
"authorized_official_title_or_position": "VP FINANCE",
"authorized_official_telephone_number": "737-257-2937"
},
"taxonomies": [
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": null,
"license": null,
"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 Apr 3, 2024; 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.