MEDICARE: ADVOCATE HEALTH AND HOSPITALS CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1639940588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVOCATE HEALTH AND HOSPITALS CORPORATION

Provider Business Mailing Address
First Line	:	29373 NETWORK PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-1293
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4025 N WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3726
Country	:	US
Telephone Number	:	847-384-3550
Fax Number	:

Authorized Official
Title or Position	:	VP MANAGED HEALTH
Name	:	KARA RICHARDSON
Credential	:
Telephone Number	:	980-416-4068

Provider Enumeration Date	:	01/10/2024
Last Update Date	:	01/28/2026

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