MEDICARE: ENDEAVOR HEALTH CLINICAL OPERATIONS

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	273R00000X	Psychiatric Hospital Unit	0005066	IL

General Provider Information

NPI Number	:	1770527236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENDEAVOR HEALTH CLINICAL OPERATIONS

Provider Business Mailing Address
First Line	:	1301 CENTRAL ST
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1613
Country	:	US
Telephone Number	:	847-570-2000
Fax Number	:	847-570-5240

Provider Business Practice Location Address
First Line	:	718 GLENVIEW AVE
Second Line	:
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-2432
Country	:	US
Telephone Number	:	847-432-8000
Fax Number	:	847-432-9305

Authorized Official
Title or Position	:	CFO
Name	:	MR. DOUGLAS D WELDAY
Credential	:
Telephone Number	:	847-570-5099

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	06/09/2025

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