Swedish Covenant Hospital

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0002717 Issued in IL

Legal business name

SWEDISH COVENANT HOSPITAL

Practice address

5145 N California Ave
Chicago, IL 60625-3661

Phone

(773) 878-8200

NPI assigned

Aug 10, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gary M Krugel

Title

Senior VP/Chief Financial Officer

Phone

(773) 907-1075

Specialties & licenses 1

Addresses

Locations

Practitioners 4

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.

• Javed Imam, M.D.

  • Medical Oncology Physician
  • Aurora, IL
  • NPI 1548271380
  NPD (past)
• Zahra Ismail, MD

  • Hematology & Oncology Physician
  • Maywood, IL
  • NPI 1124523345
  NPD (past)
• Riley Kishman, PA-C

  • Physician Assistant
  • Glenview, IL
  • NPI 1063260008
  NPD (past)
• KJ Philip, MD

  • Hematology & Oncology Physician
  • Evanston, IL
  • NPI 1598776494
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922019520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5145 N CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253661",
            "telephone_number": "773-878-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5145 N CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253661",
            "telephone_number": "773-878-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEDISH COVENANT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRUGEL",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SENIOR VP/CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "773-907-1075",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "0002717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Swedish Covenant Hospital
• Swedish Covenant Hospital (Swedish Covenant Family Practice Center)
• Swedish Covenant Hospital
• Swedish Covenant Hospital
• Swedish Covenant Hospital (Roosevelt High School Clinic)
• Swedish Covenant Hospital Home Health Care
• Swedish Covenant House Calls
• Swedish Covenant Management Services, Inc (Swedish Emergency Medicine)
• Swedish Covenant Management Services, Inc. (Comprehensive Wellness Care)
• Swedish Covenant Management Services, Inc. (Anesthesiologists of Swedish Covenant)

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.