MEDICARE: SWEDISH COVENANT HOSPITAL

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	261QS1000X	Student Health Clinic/Center

General Provider Information

NPI Number	:	1740408186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWEDISH COVENANT HOSPITAL

Provider Business Mailing Address
First Line	:	5140 N CALIFORNIA AVE
Second Line	:	SUITE 635-645
City	:	CHICAGO
State	:	IL
Zip	:	60625-3645
Country	:	US
Telephone Number	:	773-293-3223
Fax Number	:

Provider Business Practice Location Address
First Line	:	3436 W WILSON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-5318
Country	:	US
Telephone Number	:	773-534-5000
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE & BUSINESS PLAN
Name	:	SELMA KULENOVIC
Credential	:
Telephone Number	:	773-878-8200

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	08/22/2020

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