MEDICARE: ADVOCATE HEALTH AND HOSPITALS CORPORATION

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1275913063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVOCATE HEALTH AND HOSPITALS CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 70508
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-0508
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 W 95TH ST STE 205
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453-2574
Country	:	US
Telephone Number	:	773-296-3130
Fax Number	:

Authorized Official
Title or Position	:	VP MANAGED HEALTH
Name	:	KARA RICHARDSON
Credential	:
Telephone Number	:	980-416-4068

Provider Enumeration Date	:	06/05/2015
Last Update Date	:	04/21/2026

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