NPIMap

Organization Active NPI

Chicago State University

  • Clinic/Center
  • Chicago, IL
National Provider Identifier
1861928509
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
209015881 Issued in IL
Legal business name
CHICAGO STATE UNIVERSITY
Practice address
11228 S Emerald Ave
Chicago, IL 60628-4707
Phone
(773) 821-7155
NPI assigned
May 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Authorized official

Name
Dr. Lisa Young, DNP
Title
Chairperson
Phone
(773) 995-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 209015881 IL Primary

Addresses

Primary practice location

11228 S Emerald Ave
Chicago, IL 60628-4707

Mailing address

11228 S Emerald Ave
Chicago, IL 60628-4707
Phone (773) 821-7155

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1861928509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11228 S EMERALD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284707",
            "telephone_number": "773-821-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11228 S EMERALD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284707",
            "telephone_number": "773-821-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-01",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CHAIRPERSON",
        "authorized_official_telephone_number": "773-995-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "209015881",
            "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 May 1, 2017; 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.