NPIMap

Organization Active NPI

Gottlieb Memorial Hospital

  • General Acute Care Hospital
  • Melrose Park, IL
National Provider Identifier
1831170232
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
0005561 Issued in IL
Legal business name
GOTTLIEB MEMORIAL HOSPITAL
Practice address
701 W North Ave
Melrose Park, IL 60160-1612
Phone
(708) 681-3200
Fax
(708) 450-5058
NPI assigned
Nov 11, 2005
Last updated
Jun 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Authorized official

Name
Ms. Elizabeth Early
Title
President
Phone
(708) 681-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0005561 IL Primary

Addresses

Primary practice location

701 W North Ave
Melrose Park, IL 60160-1612

Mailing address

701 W North Ave
Melrose Park, IL 60160-1612
Phone (708) 681-3200

Other identifiers 1

IdentifierTypeStateIssuer
0341OtherILBLUE CROSS

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051028000728 IL Part B Supplier - Clinic/Group Practice 9234156233 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Melrose Park, IL
O20080702000040 IL Part A Provider - Hospital 9234156233 Practice locations: Melrose Park, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831170232. Details of each certification follow.

Hospital certification: CCN 140008

Legal name
GOTTLIEB MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Dec 13, 2019
Beds
274
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
701 W North Ave
Melrose Park, IL 60160-1612
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Loyola Gottlieb Memorial HospitalCCN 140008 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Gottlieb Mem Medical SE5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

676 W N Ave
Melrose PRK, IL 60160

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Charles Bareis Individual Corporate DirectorBoard Member Jan 1, 2026
Elizabeth Early Individual Corporate DirectorBoard Member Jan 1, 2026
Eva Maria Wojcik Individual Corporate DirectorBoard Member Sep 23, 2022
Sarah Hunter Individual Corporate OfficerPresident Sep 21, 2025
Corporate DirectorBoard Member Sep 21, 2025
W-2 Managing Employee Sep 21, 2025
Melissa Lukasick Individual Corporate OfficerCfo/ Treasurer Jun 28, 2019
Bertina Barnes Individual Corporate OfficerAsst Secretary Jan 1, 2025
Marc H Schwartz Individual Corporate OfficerOfficer, Chairman of the Board Oct 3, 2013
Corporate DirectorBoard Member Jan 1, 2022
Maria J Pekar Individual Corporate OfficerAssistant Secretary Jan 15, 2015
Joy V Cunningham Individual Corporate DirectorBoard Member Jan 1, 2013
Juan Gaytan Individual Corporate OfficerBoard Member Mar 28, 2025
Jill Rappis Individual Corporate OfficerSecretary Jul 8, 2011
Adenrele Adekunbi Kolawole Individual Corporate OfficerDirector Central Billing Operations Sep 27, 2019
Loyola University Health System Organization, Maywood, IL Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 1, 2008 100%
Trinity Health Corporation Organization, Livonia, MI Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Jul 1, 2011 100%
Sameer M a Qazi Individual Corporate OfficerChief Medical Officer Jun 8, 2025

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 157

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 157

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

Affiliated clinicians 575

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 575

NPI Registry JSON

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748822400000",
    "number": "1831170232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601612",
            "telephone_number": "708-681-3200",
            "fax_number": "708-450-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601612",
            "telephone_number": "708-681-3200",
            "fax_number": "708-450-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOTTLIEB MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A",
        "authorized_official_last_name": "EARLY",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-681-3200",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "0005561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0341",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

Verify at the official NPI Registry.