Provider Demographics
NPI:1912427899
Name:ADVOCATE HEALTH AND HOPSITALS CORPORATION
Entity Type:Organization
Organization Name:ADVOCATE HEALTH AND HOPSITALS CORPORATION
Other - Org Name:ADVOCATE MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:V. P.OF BUSINESS SYSTEMS
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PFIFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-795-2301
Mailing Address - Street 1:1700 LUTHER LN STE 2200
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1270
Mailing Address - Country:US
Mailing Address - Phone:847-268-8200
Mailing Address - Fax:
Practice Address - Street 1:1700 LUTHER LN STE 2200
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1270
Practice Address - Country:US
Practice Address - Phone:847-268-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVOCATE HEALTH AND HOPSITALS CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site