NPIMap

Organization Active NPI

Supplemental Health Care

  • Assisted Living Facility
  • Chicago, IL
National Provider Identifier
1972827111
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
056.007520 Issued in IL
Legal business name
SUPPLEMENTAL HEALTH CARE
Practice address
222 S Riverside PLZ
Suite 830
Chicago, IL 60606-5808
Phone
(866) 386-0773
NPI assigned
Mar 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Authorized official

Name
Theresa Hoffman, OTR/LNPI 1255655965
Title
Occupational Therapist
Phone
(312) 498-2637

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 056.007520 IL Primary

Addresses

Primary practice location

222 S Riverside PLZ
Suite 830
Chicago, IL 60606-5808

Mailing address

4902 Pine Cone CT
Apt 1
Loves Park, IL 61111-6215
Phone (312) 498-2637

National Provider Directory

National Provider Directory
Tax ID family
Supplemental42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Locations

222 S Riverside Plz
Ste 830
Chicago, IL 60606
Phone (312) 416-3804

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1972827111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4902 PINE CONE CT",
            "address_2": "APT 1",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611116215",
            "telephone_number": "312-498-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S RIVERSIDE PLZ",
            "address_2": "SUITE 830",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606065808",
            "telephone_number": "866-386-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPLEMENTAL HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-17",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "312-498-2637",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": "056.007520",
            "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 Mar 17, 2010; 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.