MEDICARE: UNION MEDICAL CENTER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	152W00000X	Optometrist
2	156FX1800X	Optician
3	163WD0400X	Diabetes Educator Registered Nurse
4	207R00000X	Internal Medicine Physician
5	207V00000X	Obstetrics & Gynecology Physician
6	207W00000X	Ophthalmology Physician
7	207Y00000X	Otolaryngology Physician
8	208000000X	Pediatrics Physician
9	2085R0202X	Diagnostic Radiology Physician
10	2085U0001X	Diagnostic Ultrasound Physician
11	208800000X	Urology Physician
12	213E00000X	Podiatrist
13	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1215951785
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNION MEDICAL CENTER

Provider Business Mailing Address
First Line	:	1649 W ADAMS ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3294
Country	:	US
Telephone Number	:	312-829-0850
Fax Number	:	312-829-4526

Provider Business Practice Location Address
First Line	:	1657 W ADAMS ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3201
Country	:	US
Telephone Number	:	312-829-0850
Fax Number	:	312-829-4526

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ROBERT H WATERS
Credential	:
Telephone Number	:	312-829-0850

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	11/14/2018

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Directions to “UNION MEDICAL CENTER ” Practice Location

Language	Start Address	Practice Location

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