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OAK STREET HEALTH: EDGEWATER NPI 1194164202


NPI Information

NPI: 1194164202
Provider Name: OAK STREET HEALTH: EDGEWATER
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 14D2060121

Address:
1541 W DEVON AVE
CHICAGO, IL
ZIP 60660
Phone: (312) 810-8763
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OAK STREET HEALTH: EDGEWATER is a primary care clinic center in Chicago, IL. OAK STREET HEALTH: EDGEWATER NPI is 1194164202. The provider is registered as an organization entity type.

The provider's business location address is:

1541 W DEVON AVE
CHICAGO, IL
ZIP 60660-313
Phone: (312) 810-8763

The provider's authorized official is Griffin Myers .
The authorized official title is Chief Medical Officer and has the following contact phone number (773) 412-3000.

The CLIA number assigned to this NPI record is 14D2060121 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/21/2013 and was last updated on 6/21/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QP2300XClinic/CenterPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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