NPIMap

Organization Active NPI

Cook County

Doing business as Dusable Adolescent Health Center

  • Student Health Clinic/Center
  • Chicago, IL
National Provider Identifier
1972623528
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
License
0004549 Issued in IL
Legal business name
COOK COUNTY
Doing business as
Dusable Adolescent Health Center
Practice address
4934 S Wabash Ave RM 165
Chicago, IL 60615-2136
Phone
(773) 548-3651
NPI assigned
Mar 29, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sandra Ankebrant
Title
Coo
Phone
(312) 864-0719

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X 0004549 IL Primary

Addresses

Primary practice location

4934 S Wabash Ave RM 165
Chicago, IL 60615-2136

Mailing address

1110 S Oakley Blvd
Room 200
Chicago, IL 60612-4218
Phone (312) 864-4665

Other names 1

  • DUSABLE ADOLESCENT HEALTH CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Triage Center67 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Locations

4934 S Wabash Ave
Rm 165
Chicago, IL 60615
Phone (773) 548-3651

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972623528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 S OAKLEY BLVD",
            "address_2": "ROOM 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124218",
            "telephone_number": "312-864-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4934 S WABASH AVE RM 165",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606152136",
            "telephone_number": "773-548-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOK COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANKEBRANT",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "312-864-0719"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "IL",
            "license": "0004549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DUSABLE ADOLESCENT HEALTH 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 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.