=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932822905
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADVOCATE HEALTH AND HOSPITALS CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/23/2022
-----------------------------------------------------
Last Update Date | 01/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3815 HIGHLAND AVE STE TG173
-----------------------------------------------------
City | DOWNERS GROVE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60515-1500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-275-3160
-----------------------------------------------------
Fax | 630-275-9165
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 208
-----------------------------------------------------
City | SHEBOYGAN
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53082-0208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP MANAGED HEALTH
-----------------------------------------------------
Name | KARA RICHARDSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 980-416-4068
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336I0012X
-----------------------------------------------------
Taxonomy Name | Institutional Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------