NPIMap

Organization Active NPI

Thorek Memorial Hospital

  • General Acute Care Hospital
  • Chicago, IL
National Provider Identifier
1982643961
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
0005371 Issued in IL
Legal business name
THOREK MEMORIAL HOSPITAL
Practice address
850 W Irving Park Rd
Chicago, IL 60613-3077
Phone
(773) 525-6780
Fax
(773) 975-3220
NPI assigned
Jun 5, 2006
Last updated
Mar 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Authorized official

Name
Edward Budd
Title
Ceo
Phone
(773) 975-6705

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0005371 IL Primary

Addresses

Primary practice location

850 W Irving Park Rd
Chicago, IL 60613-3077

Mailing address

850 W Irving Park Rd
Chicago, IL 60613-3077
Phone (773) 525-6780

Other identifiers 4

IdentifierTypeStateIssuer
0001619077OtherILBC/BS PHYSICIAN GROUP
002OtherILBC/BS
809200OtherILMEDICARE GROUP
833730OtherILMEDICARE GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040313000143 IL Part B Supplier - Clinic/Group Practice 4981593399 Receives reassigned benefits from 64 practitioners
Practice locations: Chicago, IL; Elmwood Park, IL; Lake Bluff, IL; Niles, IL; Northbrook, IL; Skokie, IL
O20100218000224 IL Part A Provider - Hospital 4981593399 Practice locations: Chicago, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982643961. Details of each certification follow.

Hospital certification: CCN 140115

Legal name
THOREK MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Feb 19, 1985
Last certification
Jul 15, 2021
Beds
218
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 30, 1937 in IL
Enrollment address
850W Irving Park Rd
Chicago, IL 60613-3077
Other Hospital Practice Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Thorek Memorial HospitalCCN 140115 · All quality measures
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

840 W Irving Park Rd
#301
Chicago, IL 60613
Phone (240) 245-0890

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Cynthia Barrera Individual Corporate OfficerAssistant Secretary Mar 1, 1999
Peter N Kamberos Individual Corporate OfficerChairman, Board of Trustees Jul 1, 1998
Corporate DirectorTrustee Mar 1, 1982 12.5%
Timothy D Heinrich Individual W-2 Managing EmployeeChief Financial Officer Sep 2, 2014
Phillip B Gorelick Individual Corporate DirectorTrustee Jun 22, 2010
Edward J Budd Individual Corporate OfficerPresident and Ceo Feb 1, 2012 100%
Operational/Managerial ControlPresident and Ceo Feb 1, 2012 100%
James E Nugent Individual Corporate OfficerVice Chairman & Vice President Jan 1, 1991
Corporate DirectorTrustee Jan 1, 1991
Robert J Baudino Individual Corporate DirectorTrustee Oct 26, 2004
Marc a Adajar Individual Corporate DirectorTrustee Jan 20, 2015

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 116

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 116

Affiliated clinicians 133

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

View all 133

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583366400000",
    "number": "1982643961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133077",
            "telephone_number": "773-525-6780",
            "fax_number": "773-975-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133077",
            "telephone_number": "773-525-6780",
            "fax_number": "773-975-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOREK MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A",
        "authorized_official_last_name": "BUDD",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-975-6705"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "0005371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PHYSICIAN GROUP",
            "identifier": "0001619077",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "002",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "809200",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "833730",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.