Healthcare Provider Details

I. General information

NPI: 1285903849
Provider Name (Legal Business Name): ADVOCATE HEALTH AND HOSPITALS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2011
Last Update Date: 12/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 HIGHLAND AVE TOWER 2 SUITE 400
DOWNERS GROVE IL
60515-1552
US

IV. Provider business mailing address

701 LEE ST SUITE 300
DES PLAINES IL
60016-4539
US

V. Phone/Fax

Practice location:
  • Phone: 630-719-4799
  • Fax: 630-963-7420
Mailing address:
  • Phone: 847-390-5900
  • Fax: 847-390-5922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: IAN STEWART
Title or Position: VP BUS. SYS, FINANCE, OPS
Credential:
Phone: 847-390-5453