JESSE BROWN VA MEDICAL CENTER (NPI# 1093011702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093011702 |
| Entity Type | Organization |
| Organization Name | JESSE BROWN VA MEDICAL CENTER |
| Practice Address |
820 S Damen Ave Chicago IL 60612-3728 |
| Mailing Address |
6544 N Longmeadow Ave Lincolnwood IL 60712-3206 |
| Practice Telephone | 3125697271 |
| Mailing Telephone | 8479330093 |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2011-01-28 |
| Authorized Official Name | DR. S. JOSEPH MAURICE (CONSULTANT) |
| Authorized Official Telephone | 3125697271 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QV0200X |
Clinic/Center Specialization: VA |
036037238 | IL | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932438108 | Jesse Brown Va Medical Center | Rehabilitation Hospital | 215 W 59th St, Apt 17, Hinsdale, IL 60521-4973 | 2009-12-16 |
| 1083655336 | Jesse Brown Va Medical Center | Clinic/Center | 820 S Damen, Chicago, IL 60612 | 2006-06-09 |
| 1255371928 | Jesse Brown Va Medical Center | General Acute Care Hospital | Pm&r (117), 820 South Damen Ave, Chicago, IL 60612 | 2006-06-08 |
| 1851650360 | Jesse Brown Va Medical Center | General Acute Care Hospital | 820 S Damen Ave, Chicago, IL 60612-3728 | 2012-05-04 |
| 1871860346 | Jesse Brown Va Medical Center | Dietitian, Registered | 820 S Damen Ave, Chicago, IL 60612-3728 | 2011-11-28 |
| 1013131085 | Jesse Brown Va Medical Center | Military Hospital | 820 S Damen Ave, Chicago, IL 60612-3728 | 2007-04-12 |
| 1750321303 | Jesse Brown Va Medical Center | Clinic/Center | 820 S Damen Ave, Chicago, IL 60612-3728 | 2006-06-08 |
| 1649219189 | Jesse Brown Va Medical Center | Clinic/Center | 820 S Damen Ave, Chicago, IL 60612-3728 | 2006-06-06 |
| 1497716922 | Jesse Brown Va Medical Center | Military Hospital | 820 S Damen Ave, Chicago, IL 60612-3728 | 2006-04-02 |
| Street Address |
820 S DAMEN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-3728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679561260 | Jesse Brown Veterans Administration Hospital | General Acute Care Hospital | 820 S Damen Ave, Chicago, IL 60612-3728 | 2005-10-09 |
| 1528678463 | Jennifer Lee | Pharmacist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-08-05 |
| 1770101115 | Natalia Irena Szynalik | Pharmacist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-07-13 |
| 1568088706 | Benjamin Galloway | Podiatrist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-06-23 |
| 1588280937 | Laine Ferrill | Pharmacist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-06-22 |
| 1598380560 | Regan Kelley | Speech-Language Pathologist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-06-15 |
| 1609490531 | Jacob Conditt | Student in an Organized Health Care Education/Training Program | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-06-06 |
| 1023632551 | Stephen Macrowski | Dentist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-06-01 |
| 1588286256 | Nisha Utpal Patel | Dentist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-05-15 |
| 1568084804 | Tuhin Mukherjee | Podiatrist | 820 S Damen Ave, Chicago, IL 60612-3728 | 2020-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
| Find all providers in zip 60612 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
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|---|---|---|---|---|
| 1669860458 | Chicago Vamc | Clinic/Center | 1141 South California Avenue, Chicago, IL 60608-9998 | 2014-12-31 |
| 1568402378 | Chicago Vamc | Clinic/Center | 7731 S Halsted St, Chicago, IL 60620-2412 | 2006-06-08 |
| 1639126535 | Chicago Vamc | Clinic/Center | 211 E Ontario St, 12th Floor, Chicago, IL 60611-3468 | 2006-05-27 |
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| 1437636966 | Miracle Healthcare LLC | Clinic/Center | 2024 Hickory Rd Ste 306, Homewood, IL 60430 | 2018-07-26 |
| 1558751776 | St. Louis Jc Vamc | Clinic/Center | 3403 Heartland Street, Marion, IL 62959-6393 | 2015-01-26 |
| 1992067995 | St. Louis Jc Vamc | Clinic/Center | 1130 E Walnut St, Suite 100, Carbondale, IL 62901-5007 | 2012-06-14 |
| 1497012652 | St. Louis Jc Vamc | Clinic/Center | 608 Rollie Moore Drive, Harrisburg, IL 62946-9998 | 2012-04-12 |
| 1851660724 | Omaha Vamc | Clinic/Center | 406 Avenue C, Sterling, IL 61081-3407 | 2011-12-22 |
| 1902840622 | St. Louis Jc Vamc | Clinic/Center | 4105 N Water Tower Pl, Mount Vernon, IL 62864-6296 | 2006-06-15 |
| 1629016845 | Omaha Vamc | Clinic/Center | 6020 Broadway St, Quincy, IL 62305-7919 | 2006-06-02 |
| 1902843360 | Oak Park Va Clinic | Clinic/Center | 149 S Oak Park Ave, Oak Park, IL 60302-2901 | 2006-06-02 |
| 1154368710 | Hines Vamc | Clinic/Center | 10201 S Cicero Ave, Oak Lawn, IL 60453-4023 | 2006-06-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.