MEDICARE: ADVOCATE NORTH SIDE HEALTH NETWORK

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	273R00000X	Psychiatric Hospital Unit	0005165	IL

General Provider Information

NPI Number	:	1639657414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVOCATE NORTH SIDE HEALTH NETWORK

Provider Business Mailing Address
First Line	:	836 W WELLINGTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-5147
Country	:	US
Telephone Number	:	773-975-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	836 W WELLINGTON AVE.
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657
Country	:	US
Telephone Number	:	773-975-1600
Fax Number	:

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

Provider Enumeration Date	:	08/02/2018
Last Update Date	:	01/28/2026

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