NPIMap

Organization Active NPI

Advocate North Side Health Network

Doing business as Advocate Illinois Masonic Medical Center

  • General Acute Care Hospital
  • Chicago, IL
National Provider Identifier
1912014564
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
282N00000X Issued in IL
Legal business name
ADVOCATE NORTH SIDE HEALTH NETWORK
Doing business as
Advocate Illinois Masonic Medical Center
Practice address
836 W Wellington Ave
Chicago, IL 60657-5147
Phone
(773) 975-1600
NPI assigned
Aug 23, 2006
Last updated
Jan 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 273R00000X IL
Rehabilitation Hospital Unit 273Y00000X 273Y00000X IL
General Acute Care Hospital 282N00000X 282N00000X IL Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

836 W Wellington Ave
Chicago, IL 60657-5147

Mailing address

836 W Wellington Ave
Chicago, IL 60657-5147
Phone (773) 975-1600

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20061205000391 IL Part A Provider - Hospital 9537063904 Practice locations: Park Ridge, IL; Chicago, IL; Libertyville, IL; Barrington, IL; Downers Grove, IL
O20110119000254 IL Part A Provider - Hospital 9537063904 1 other NPI on this enrollment
Practice locations: Chicago, IL
O20130910000866 IL Part A Provider - Hospital 9537063904 1 other NPI on this enrollment
Practice locations: Chicago, IL
O20230905000189 IL Part B Supplier - Clinic/Group Practice 9537063904 Receives reassigned benefits from 21 practitioners
Practice locations: Chicago, IL

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1912014564. Details of each certification follow.

Hospital certification: CCN 140182

Legal name
ADVOCATE NORTH SIDE HEALTH NETWORK
Doing business as
ADVOCATE ILLINOIS MASONIC MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Nov 9, 2018
Beds
997
Ownership / control type
Private (not for profit)
Most recent change of ownership
Nov 3, 2000 (1 total)
Organization structure
CorporationNon-profit
Enrollment address
836 W Wellington Ave
Chicago, IL 60657-5147
Main/Primary Hospital Location
Hospital subgroups
General

Hospital certification: CCN 14S182

Legal name
ADVOCATE NORTH SIDE HEALTH NETWORK
Doing business as
ADVOCATE ILLINOIS MASONIC MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Apr 27, 1981 in IL
Enrollment address
836 W Wellington Ave
Chicago, IL 60657-5147
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Hospital certification: CCN 14T182

Legal name
ADVOCATE NORTH SIDE HEALTH NETWORK
Doing business as
ADVOCATE ILLINOIS MASONIC MEDICAL CENTER
Organization structure
CorporationNon-profit
Enrollment address
836 W Wellington Ave
Chicago, IL 60657-5147
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Advocate Illinois Masonic Medical CenterCCN 140182 · 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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Advocate Illinois Masonic Medical CenterCCN 14T182 · All quality measures
Ownership
Non-profit
Certified
Nov 1, 1983

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

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Dia Nichols Individual Corporate OfficerPresident Oct 1, 2024
Corporate Director Oct 1, 2024
Advocate Health Care Network Organization, Oak Brook, IL Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 1997 100%
Gail D Hasbrouck Individual Corporate DirectorDirector Jan 1, 2004
Corporate Director Jan 1, 2004
Clarence Nixon Individual Corporate OfficerChairperson Jan 1, 2025
Corporate Director Oct 1, 2005
Tori Munnik Individual Corporate OfficerAssistant Treasurer Jun 3, 2026
Rachelle Hart Individual Corporate OfficerSecretary Jun 14, 2023
Kara Richardson Individual Corporate OfficerAsst. Treasurer Oct 1, 2024
David B Anderson Individual Corporate Director Oct 1, 2008
Lindsay Durgin Individual Corporate OfficerTreasurer Jul 1, 2025
Matthew Primack Individual W-2 Managing EmployeeHospital President May 19, 2025
Rachel Halverson Individual Corporate OfficerAssistant Treasurer Jun 14, 2023
Desiree Millet Individual Corporate OfficerAssistant Treasurer Jun 3, 2026
Nathaniel L Edmond Individual Corporate OfficerVice Chairperson Jan 1, 2025
Corporate Director Jun 1, 2013
Harold James Jr Slinkman Individual Corporate OfficerAssistant Secretary Jun 14, 2023
Advocate Health and Hospitals Corporation Organization, Oak Brook, IL Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Mar 18, 2011 100%
Advocate Health Inc Organization, Charlotte, NC Corporation, Non-profit Operational/Managerial Control Dec 2, 2022
Mark M Harris Individual Corporate Director Oct 1, 2005
Advocate Aurora Health, Inc. Organization, Milwaukee, WI Created for acquisition, Non-profit 5% Or Greater Indirect Ownership Interest Apr 1, 2018 100%
Operational/Managerial Control Apr 1, 2018 100%
Kathie S Bender Schwich Individual Corporate Director Jun 11, 2023

Facilities with the same owner 92

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

View all 92

Practitioners & affiliated clinicians

Practitioners 50

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 50

Affiliated clinicians 870

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

View all 870

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1912014564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "773-975-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "773-975-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVOCATE NORTH SIDE HEALTH NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "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": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "IL",
            "license": "273R00000X",
            "primary": false
        },
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "IL",
            "license": "273Y00000X",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "282N00000X",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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

Verify at the official NPI Registry.