MEDICARE: PORTERCARE ADVENTIST HEALTH SYSTEM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1194680702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PORTERCARE ADVENTIST HEALTH SYSTEM

Provider Business Mailing Address
First Line	:	PO BOX 713425
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-4325
Country	:	US
Telephone Number	:	800-953-0104
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525 S DOWNING ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-5817
Country	:	US
Telephone Number	:	303-765-6893
Fax Number	:	303-778-2459

Authorized Official
Title or Position	:	COO
Name	:	JASON TACHA
Credential	:
Telephone Number	:	303-304-7752

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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Directions to “PORTERCARE ADVENTIST HEALTH SYSTEM ” Practice Location

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