Provider Demographics
NPI:1912936014
Name:ADVOCATE HEALTH & HOSPITALS CORPORATION
Entity Type:Organization
Organization Name:ADVOCATE HEALTH & HOSPITALS CORPORATION
Other - Org Name:ADVOCATE CHRIST MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP FINANCIAL OPS
Authorized Official - Prefix:
Authorized Official - First Name:NAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-299-1610
Mailing Address - Street 1:8550 W BRYN MAWR AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3222
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:847-390-5450
Practice Address - Street 1:4440 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2600
Practice Address - Country:US
Practice Address - Phone:847-390-5900
Practice Address - Fax:847-390-5450
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVOCATE HEALTH & HOSPITALS CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-01
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL206017Medicare PIN