Covenant Home of Chicago

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

COVENANT HOME OF CHICAGO

Practice address

2720 West Foster Avenue
Chicago, IL 60625-3510

Phone

(773) 506-6900

Fax

(773) 878-4530

NPI assigned

Feb 1, 2011

Organization subpart

Yes

Parent organization

COVENANT RETIREMENT COMMUNITIESAs reported in NPPES

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

Authorized official

Name

Mr. David G Erickson, J.D.

Title

Vice President

Phone

(773) 878-2294

Specialties & licenses 1

Addresses

Part of

Covenant Home of Chicago

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

{
    "created_epoch": "1296518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296518400000",
    "number": "1982900445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 WEST FOSTER AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253510",
            "telephone_number": "773-506-6900",
            "fax_number": "773-878-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 WEST FOSTER AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253510",
            "telephone_number": "773-506-6900",
            "fax_number": "773-878-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HOME OF CHICAGO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COVENANT RETIREMENT COMMUNITIES",
        "enumeration_date": "2011-02-01",
        "last_updated": "2011-02-01",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "773-878-2294",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "J.D."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicolas Jose Covelli III, MSW
• Nicole Covello
• Rebecca Lynn Coven, OTR/L
• Covenant Care Therapy LTD.
• Covenant Healthcare Services & Staffing Inc.
• Coventry Counseling PLLC
• Coventry Village Healthcare
• Ryan Coventry, M.A.
• Evelynn Cover
• Covert Minds Therapy

• Assisted Living Facility in Chicago, IL
• Providers in Chicago, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; 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.