Healthcare Provider Details

I. General information

NPI: 1154713980
Provider Name (Legal Business Name): SAINT ANTHONY HEALTH AFFILIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2015
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3059 W 26TH ST
CHICAGO IL
60623-4131
US

IV. Provider business mailing address

1340 S DAMEN AVE
CHICAGO IL
60608-1169
US

V. Phone/Fax

Practice location:
  • Phone: 773-696-9490
  • Fax: 773-376-3720
Mailing address:
  • Phone: 773-484-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DENNIS O ANOSIKE
Title or Position: CFO
Credential:
Phone: 773-484-1000