Organization Active NPI

Saint Mary of Nazareth Hospital - Chicago LLC

Doing business as Prime Healthcare Rx 1001

  • Community/Retail Pharmacy
  • Chicago, IL
National Provider Identifier
1871387043
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SAINT MARY OF NAZARETH HOSPITAL - CHICAGO LLC
Doing business as
Prime Healthcare Rx 1001
Practice address
2233 W Division St
Chicago, IL 60622-8151
Phone
(312) 770-3444
NPI assigned
Apr 4, 2025
Last updated
Apr 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Authorized official

Name
Christopher Doan
Title
Managing Associate General Counsel
Phone
(310) 259-4706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

2233 W Division St
Chicago, IL 60622-8151

Mailing address

2233 W Division St
Chicago, IL 60622-8151
Phone (312) 770-3444

Other names 1

  • Prime Healthcare Rx 1001 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250627000424 IL Part B Supplier - Pharmacy 6103348479 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chicago, IL

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1743724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743724800000",
    "number": "1871387043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606228151",
            "telephone_number": "312-770-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606228151",
            "telephone_number": "312-770-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT MARY OF NAZARETH HOSPITAL - CHICAGO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-04",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prime Healthcare Rx 1001",
            "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 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.