EDWARD HINES JR. VA HOSPITAL (NPI# 1760618680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760618680 |
| Entity Type | Organization |
| Organization Name | EDWARD HINES JR. VA HOSPITAL |
| Practice Address |
5000 S 5th Ave Bldg 228 Hines IL 60141-3030 |
| Mailing Address |
5000 S. 5th Avenue Hines IL 60141 |
| Practice Telephone | 7082028387 |
| Mailing Telephone | 7082028387 |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2009-06-05 |
| Authorized Official Name | PEGGY JENE MORRIS (ADDICTION THERAPIST) |
| Authorized Official Telephone | 7739882878 |
| Authorized Official Credential | CADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 276400000X | Rehabilitation, Substance Use Disorder Unit | IL | Hospital Units |
| 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 |
| 1518314970 | Edward Hines Jr. Va Hospital | Clinic/Center | 5000 S 5th Ave, Hines, IL 60141-3030 | 2016-05-16 |
| 1427329226 | Edward Hines Jr. Va Hospital | Military Hospital | 5000 S 5th Ave, Hines, IL 60141-3030 | 2012-01-25 |
| 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 BLDG 228 |
| 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 | 276400000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation, Substance Use Disorder Unit |
| A distinct part of a hospital that provides medically monitored, interdisciplinary addiction-focused treatment to patients/clients who have psychoactive substance use disorders (commonly referred to as alcohol and drug abuse or substance abuse.) |
| Notes: Source: Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336382514 | Edward J. Hines Hospital | Rehabilitation, Substance Use Disorder Unit | 5000 S 5th Ave, Hines, IL 60141-3030 | 2009-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619460326 | Safer Foundation | Rehabilitation, Substance Use Disorder Unit | 808 S Kedzie Ave, Chicago, IL 60612-3929 | 2018-06-08 |
| 1891286266 | International Word Out Ministries | Rehabilitation, Substance Use Disorder Unit | 1139 W Vermont Ave, Calumet Park, IL 60827-6520 | 2018-05-22 |
| 1962877332 | Salud Dental LLC | Rehabilitation, Substance Use Disorder Unit | 334 S. Neltnor Blvd Unit # G, West Chicago, IL 60185 | 2015-12-10 |
| 1083884019 | Bridging The Tys To Jordan Inc | Rehabilitation, Substance Use Disorder Unit | 7122 S Vincennes Ave, Suite B, Chicago, IL 60621-2661 | 2008-03-05 |
| 1992973689 | Specialized Assistance Services, Nfp | Rehabilitation, Substance Use Disorder Unit | 2630 S. Wabash, Chicago, IL 60616 | 2008-02-14 |
| 1356955744 | Solutions Counseling and Consulting Group | Rehabilitation, Substance Use Disorder Unit | 11740 S Western Ave, Chicago, IL 60643-4732 | 2020-09-02 |
| 1982212205 | Steppin Stone Inc | Rehabilitation, Substance Use Disorder Unit | 7244 W Benton Dr, Frankfort, IL 60423-9303 | 2020-07-22 |
| 1770144925 | Association for Individual Development | Rehabilitation, Substance Use Disorder Unit | 1230 N Highland Ave, Aurora, IL 60506-1401 | 2019-06-27 |
| 1104301688 | Family Counseling Service of Aurora | Rehabilitation, Substance Use Disorder Unit | 84 Templeton Dr, Oswego, IL 60543-7008 | 2018-10-01 |
| 1285151704 | Safer Foundation | Rehabilitation, Substance Use Disorder Unit | 3210 W Arthington St, Chicago, IL 60624-4121 | 2017-08-25 |
| 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.