MERCY PHILLIPS HEALTH CENTER NPI 1730310251

NPI Information

NPI: 1730310251
Provider Name: MERCY PHILLIPS HEALTH CENTER
Classification: Clinic/Center - 261QS1000X
Entity Type: Organization

Specialization: Student Health

CLIA Number: 14D1036279

Address:
244 E PERSHING RD
CHICAGO, IL
ZIP 60653
Phone: (312) 567-7058
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MERCY PHILLIPS HEALTH CENTER is a student health clinic center in Chicago, IL. MERCY PHILLIPS HEALTH CENTER NPI is 1730310251. The provider is registered as an organization entity type.

The provider's business location address is:

244 E PERSHING RD
CHICAGO, IL
ZIP 60653-222
Phone: (312) 567-7058
Fax: (312) 328-7982

The provider's authorized official is Patrice Kathleen Griffin .
The authorized official title is Delegated Official and has the following contact phone number (312) 567-5593.

The CLIA number assigned to this NPI record is 14D1036279 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/31/2009 and was last updated on 7/13/2017.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	291U00000X	Clinical Medical Laboratory		771115016	ILLINOIS	No
2	261QS1000X	Clinic/Center	Student Health	0001578	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	14D1036279	OTHER	ILLINOIS	CLIA
2	771115016	OTHER	ILLINOIS	DHS

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

NPI Synchronization or Removal

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