NPIMap

Organization Active NPI

Advocate Northside Health System

Doing business as Advocate Illinois Masonic Medical Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
National Provider Identifier
1861774408
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
04004 Issued in IL
Legal business name
ADVOCATE NORTHSIDE HEALTH SYSTEM
Doing business as
Advocate Illinois Masonic Medical Center
Practice address
913 W Wellington Ave FL 2
Chicago, IL 60657-6709
Phone
(873) 843-0200
NPI assigned
Sep 9, 2011
Last updated
Apr 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Authorized official

Name
Kara Richardson
Title
VP Managed Health
Phone
(980) 416-4068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 04004 IL Primary

Addresses

Primary practice location

913 W Wellington Ave FL 2
Chicago, IL 60657-6709

Mailing address

PO Box 70508
Chicago, IL 60673-0508

Other identifiers 1

IdentifierTypeStateIssuer
04004MedicaidIL

Other names 1

  • ADVOCATE ILLINOIS MASONIC MEDICAL CENTER Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

National Provider Directory

National Provider Directory
Tax ID family
Advocate Northside HLTH22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

21312 Network Pl
Chicago, IL 60673

913 W Wellington Ave
Fl 2
Chicago, IL 60657
Phone (872) 843-0200

938 W Nelson St
Chicago, IL 60657
Phone (773) 296-3220

Practitioners & affiliated clinicians

Practitioners 1

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": "1315526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1861774408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70508",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606730508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 W WELLINGTON AVE FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576709",
            "telephone_number": "873-843-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCATE NORTHSIDE HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-09",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "KARA",
        "authorized_official_title_or_position": "VP MANAGED HEALTH",
        "authorized_official_telephone_number": "980-416-4068"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "04004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04004",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ADVOCATE ILLINOIS MASONIC MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ADVOCATE ILLINOIS MASONIC MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 21, 2026; 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.