Healthcare Provider Details

I. General information

NPI: 1962317784
Provider Name (Legal Business Name): SWEDISH COVENANT HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5145 N CALIFORNIA AVE
CHICAGO IL
60625-3661
US

IV. Provider business mailing address

5145 N CALIFORNIA AVE
CHICAGO IL
60625-3661
US

V. Phone/Fax

Practice location:
  • Phone: 773-878-8200
  • Fax: 773-293-4371
Mailing address:
  • Phone: 773-878-8200
  • Fax: 773-293-4371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: SHAUN WALDER
Title or Position: SYSTEM VP PFS
Credential:
Phone: 630-646-3702