Healthcare Provider Details

I. General information

NPI: 1356253801
Provider Name (Legal Business Name): ADVOCATE HEALTH AND HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 S DAMEN AVE
CHICAGO IL
60612-3727
US

IV. Provider business mailing address

5139 JARVIS AVE
SKOKIE IL
60077-3464
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-7800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name: AQSSA KHIYANI
Title or Position: DNP STUDENT
Credential: RN
Phone: 872-235-7953