EDWARD HINES JR. VA HOSPITAL (NPI# 1518314970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518314970 |
| Entity Type | Organization |
| Organization Name | EDWARD HINES JR. VA HOSPITAL |
| Practice Address |
5000 S 5th Ave Hines IL 60141-3030 |
| Practice Telephone | 7082028387 |
| Mailing Telephone | 7082028387 |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2016-05-16 |
| Authorized Official Name | MS. LINDSAY JO HOFFMAN (CLINICAL DIETITIAN) |
| Authorized Official Telephone | 7082028387 |
| Authorized Official Credential | MS, RD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QV0200X |
Clinic/Center Specialization: VA |
Ambulatory Health Care Facilities | ||
| Y | 284300000X | Special Hospital | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013212356 | Edward Hines Jr. Va Hospital | Military Hospital | 5800 W 105th St, Unit 2a, Oak Lawn, IL 60453-4385 | 2011-01-18 |
| 1013440361 | Edward Hines Jr. Va Hospital | Military Hospital | 5000 S 5th Ave, Hines, IL 60141-3030 | 2017-04-04 |
| 1427329226 | Edward Hines Jr. Va Hospital | Military Hospital | 5000 S 5th Ave, Hines, IL 60141-3030 | 2012-01-25 |
| 1760618680 | Edward Hines Jr. Va Hospital | Rehabilitation, Substance Use Disorder Unit | 5000 S 5th Ave, Bldg 228, Hines, IL 60141-3030 | 2009-06-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EDWARD HINES JR VA HOSPITAL | 5000 S 5th Ave, Hines, IL 60141-3030 |
| Street Address |
5000 S 5TH AVE |
| City | HINES |
| State | IL |
| Zip Code | 60141-3030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508865452 | Patricia M Knisley | Dietitian, Registered | 5000 S 5th Ave, Food and Nutrition Services (120d), Hines, IL 60141-3030 | 2005-07-21 |
| 1821699273 | Matthew Nakeem Williams | Registered Nurse | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-11-03 |
| 1225638877 | Christine Marie Desparrois | Technician/Technologist | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-10-31 |
| 1558961565 | Maggie Elizabeth Murphy | Music Therapist | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-10-28 |
| 1689273781 | Carrie Gatz | Music Therapist | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-10-20 |
| 1124626304 | Anne Kathryn Thorndyke | Pharmacist | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-10-11 |
| 1033726781 | Josmi Joseph | Pharmacist | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-09-28 |
| 1558975003 | Phillip M Christenson | Social Worker | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-09-02 |
| 1730793266 | Tanya Elaine Pringle | Social Worker | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-09-02 |
| 1912518796 | Dana Viola Shepherd | Pharmacist | 5000 S 5th Ave, Hines, IL 60141-3030 | 2020-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992273056 | Donizetti Razo | Social Worker | 5000 S. Fifth Avenue, Building 228, Room 4078, Hines, IL 60141 | 2018-11-07 |
| 1558838086 | Michael Calia | Social Worker | Patient Advocate Office #122, Edward Hines Jr. Va Hospital, 5000 S. 5th Avenue, Hines, IL 60141 | 2018-11-02 |
| 1639684640 | David Alan Edwards | Specialist/Technologist | 5000 S 5ht Ave, Building 113, Hines, IL 60141 | 2017-12-13 |
| 1689189706 | Joseph Jorgenson | Rehabilitation Practitioner | Hines Brc Bld 113, 5000 S 5th Ave, 124, Hines, IL 60141 | 2017-12-12 |
| 1154836823 | Kristy Bassett | Social Worker | 5000 S 5th Ave Bldg 2284n, Hines, IL 60141 | 2017-12-04 |
| 1396269387 | Aaron Jerome Brown | Kinesiotherapist | 5000 S 5th. Ave., Hines, IL 60141 | 2017-08-01 |
| 1932454634 | Michael Ladra Marquez | Physical Therapist | 5000 South 5th Ave., Edward Hines Jr. Va Hospital, Hines, IL 60141 | 2012-07-18 |
| 1437489713 | Linda Christime Bronski | Social Worker | Fifth Ave and Roosevelt Ave Bldg 228, Edward Hines Jr Va Hospital, Hines, IL 60141 | 2010-01-08 |
| 1700113859 | Sarah Jean Ostrowski | Recreation Therapist | 2100 S 5th Ave, Hines, IL 60141 | 2009-11-11 |
| 1841447299 | Narayanarao Madamala | Pharmacist | Hines Consolidated Mail Out Pharmacy, Building 37nw, Hines, IL 60141 | 2008-08-27 |
| Find all providers in zip 60141 | ||||
| Taxonomy Code | 284300000X |
| Grouping | Hospitals |
| Classification | Special Hospital |
| A designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have specified medical conditions, both surgical and nonsurgical. |
| Notes: Source: AHA Guide, Registration section, p. A5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679939417 | Kyuhun Park | Special Hospital | 2540 N Harlem Ave, Elmwood Park, IL 60707-2046 | 2016-01-09 |
| 1902210164 | Alexis De Gale | Special Hospital | 1050 Bonaventure Dr, Elk Grove Village, IL 60007-3277 | 2014-06-16 |
| 1417369976 | Arthur Berg | Special Hospital | 14 Bradford Ln, Oak Brook, IL 60523-2322 | 2014-06-02 |
| 1063823557 | Beaumont Small Animal Clinic | Special Hospital | 1304 N Cunningham Ave, Urbana, IL 61802-1817 | 2014-05-19 |
| 1932407772 | Kevin Wayne Ames | Special Hospital | 2005 Mall St, Collinsville, IL 62234-1832 | 2011-03-02 |
| 1366645590 | Jeremy Peter Buishas | Special Hospital | 21 S. Park Blvd, Glen Ellyn, IL 60137 | 2007-06-06 |
| 1508073347 | Ciwirc ( Central Illinois Work Injury Resource Center ) | Special Hospital | 736 Sw Washington St Ste 2a, Peoria, IL 61602-1643 | 2007-05-17 |
| 1851731640 | Southern Illinois University School of Medicine | Special Hospital | 701 N 1st St, Room D443, Springfield, IL 62702-3757 | 2013-06-26 |
| 1396083796 | County Line Animal Hospita | Special Hospital | 2200 S Washington St, Naperville, IL 60565-2495 | 2013-01-21 |
| 1184998627 | Patrice Kathleen Griffin | Special Hospital | 2525 S Michigan Ave, B-522, Chicago, IL 60616-2333 | 2012-03-01 |
| Find all providers with the same taxonomy | ||||
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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.