ROSELAND COMMUNITY HOSPITAL ASSOCIATION (NPI# 1306029889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306029889 |
| Entity Type | Organization |
| Organization Name | ROSELAND COMMUNITY HOSPITAL ASSOCIATION |
| Other Organization Name | ROSELAND COMMUNITY HOSPITAL |
| Practice Address |
45 W 111th St Chicago IL 60628-4200 |
| Mailing Address |
5501 West 79th Street Suite 400 Burbank IL 60459-2190 |
| Practice Telephone | 7739953000 |
| Practice Fax Number | 7739956602 |
| Mailing Telephone | 7739953000 |
| Mailing Fax Number | 7739956602 |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2016-11-29 |
| Authorized Official Name | MR. MARLO V KEMP (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 7739953000 |
| Authorized Official Credential | CFO |
| Is Organization Subpart | Y |
| Parent Organization Name | ROSELAND COMMUNITY HOSPITAL ASSOCIATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 2083P0011X |
Preventive Medicine Specialization: Undersea and Hyperbaric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | 036117915 | IL | Allopathic & Osteopathic Physicians |
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 01622034 | 01 | |
| IL | BLUE SHIELD | 01622034 | 01 |
| Other Name | Type Code |
|---|---|
| Roseland Community Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265997142 | Roseland Community Hospital Association | Dentist | 45 W 111th St, Chicago, IL 60628-4200 | 2019-02-05 |
| 1619417979 | Roseland Community Hospital Association | Pharmacy | 45 W 111th St, Chicago, IL 60628-4200 | 2017-03-06 |
| 1568472819 | Roseland Community Hospital Association | Psychiatry & Neurology | 45 W 111th St, Chicago, IL 60628-4200 | 2006-08-09 |
| Street Address |
45 W 111TH ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60628-4200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245222454 | Carl Vancol | Family Medicine | 45 W 111th St, Suite 304, Chicago, IL 60628-4200 | 2005-08-16 |
| 1740897149 | Healthcare Alternative Systems, Inc. | Clinic/Center | 45 W 111th St, Chicago, IL 60628-4200 | 2020-09-29 |
| 1659988053 | Healthcare Alternative Systems, Inc. | Clinic/Center | 45 W 111th St, Chicago, IL 60628-4200 | 2020-09-29 |
| 1003371717 | Shakira Ayanlaja | Nurse Practitioner | 45 W 111th St, Chicago, IL 60628-4200 | 2019-02-06 |
| 1265997142 | Roseland Community Hospital Association | Dentist | 45 W 111th St, Chicago, IL 60628-4200 | 2019-02-05 |
| 1063918555 | Brenda Beben | Dietitian, Registered | 45 W 111th St, Chicago, IL 60628-4200 | 2018-04-03 |
| 1730687591 | Tranisha Lynette Lucas | Nurse Practitioner | 45 W 111th St, Chicago, IL 60628-4200 | 2018-01-26 |
| 1386152395 | Rjm Wellness Corp | Internal Medicine | 45 W 111th St, Chicago, IL 60628-4200 | 2018-01-12 |
| 1760998280 | Anum Haq | Physician Assistant | 45 W 111th St, Chicago, IL 60628-4200 | 2017-12-20 |
| 1780110346 | Roxanne Spurlark | Nurse Practitioner | 45 W 111th St, Chicago, IL 60628-4200 | 2017-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750857942 | Myrna Pledger | Counselor | 259 W. 104th Pl., Chicago, IL 60628 | 2018-10-16 |
| 1073097184 | 4every1 Lab Inc. | Clinical Medical Laboratory | 10723 S Halsted St, Chicago, IL 60628 | 2018-09-24 |
| 1922594613 | Northwest Adult Wellness Center LLC | Clinic/Center | 235 W 95th Suite 3, Chicago, IL 60628 | 2018-07-05 |
| 1285152801 | Brittany Bellamy | Developmental Therapist | 10333 S Prairie, Chicago, IL 60628 | 2017-09-04 |
| 1598293839 | Denise Marie Mercherson | Social Worker | 9561 S. Union, Chicago, IL 60628 | 2017-05-31 |
| 1659821221 | Tca Health Care | Dentist | 1030 E. 130th St, Chicago, IL 60628 | 2016-10-07 |
| 1528432697 | Global Dialysis, LLC | Registered Nurse | 9746 South Harvard Ave., Chicago, IL 60628 | 2015-11-30 |
| 1871966382 | Kirby Rehabilitation, Inc | Clinic/Center | 723 W. 111th St, Chicago, IL 60628 | 2015-11-05 |
| 1851638605 | Marketa Marvanova | Pharmacist | 9501 S. King Drive, Douglas Hall 203-23, Chicago State University College of Pharmacy, Chicago, IL 60628 | 2013-01-14 |
| 1841567377 | Emma Goodman | Pharmacist | 10620 S. Halsted St, Chicago, IL 60628 | 2011-11-29 |
| Find all providers in zip 60628 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699382531 | Contemporary Ob/gyn Chicago, Pllc | Obstetrics & Gynecology | 2007 S State St, Chicago, IL 60616-2173 | 2020-09-24 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1679003826 | Scolastica W Njoroge | Obstetrics & Gynecology | 5841 S Maryland Ave Rm J-141, Chicago, IL 60637-1447 | 2017-06-19 |
| 1356794457 | Paige Dermer Kendall | Obstetrics & Gynecology | 250 E. Huron Street, Chicago, IL 60611 | 2016-07-13 |
| 1427409093 | Marly Francois | Obstetrics & Gynecology | 1300 W Belmont Ave Ste 100, Chicago, IL 60657-3200 | 2016-06-24 |
| 1346695509 | Kristina Janea Warner | Obstetrics & Gynecology | 250 E Superior St Ste 5-2166, Chicago, IL 60611-2914 | 2016-04-25 |
| 1962857102 | Jacqueline Christine Lee | Obstetrics & Gynecology | 250 E Superior St Ste 5-2177, Chicago, IL 60611-2914 | 2016-04-25 |
| 1881049120 | Kelly Ann Davis | Obstetrics & Gynecology | 7447 W Talcott Ave Ste 531, Chicago, IL 60631-3716 | 2016-04-24 |
| 1780046185 | Hillary Edelman | Obstetrics & Gynecology | 900 N Kingsbury St Ste 130n, Chicago, IL 60610-7457 | 2016-03-24 |
| 1578929139 | Olivia Helen Finkelstein Barry | Obstetrics & Gynecology | 675 N Saint Clair St # 200, Chicago, IL 60611 | 2016-01-12 |
| Find all providers in CHICAGO | ||||
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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.