SOUTH SHORE HOSPITAL CORPORATION (NPI# 1053391359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053391359 |
| Entity Type | Organization |
| Organization Name | SOUTH SHORE HOSPITAL CORPORATION |
| Practice Address |
8012 S Crandon Ave Finance Department Chicago IL 60617-1124 |
| Practice Telephone | 7733565312 |
| Practice Fax Number | 7737688154 |
| Mailing Telephone | 7733565312 |
| Mailing Fax Number | 7737688154 |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. TIMOTHY ARTHUR CAVENEY (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 7733565312 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 1706462 | IL | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 510204952001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225479470 | South Shore Hospital Corporation | Dietitian, Registered | 8012 S Crandon Ave, Chicago, IL 60617-1124 | 2013-07-16 |
| 1689935397 | South Shore Hospital Corporation | Psychiatric Unit | 8012 S Crandon Ave, Chicago, IL 60617-1124 | 2012-05-30 |
| 1861569253 | South Shore Hospital Corporation | General Acute Care Hospital | 8012 S Crandon Ave, Chicago, IL 60617-1124 | 2006-11-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SOUTH SHORE HOSPITAL CORPORATION | 8012 S Crandon Ave, Chicago, IL 60617-1124 |
| Street Address |
8012 S CRANDON AVE FINANCE DEPARTMENT |
| City | CHICAGO |
| State | IL |
| Zip Code | 60617-1124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871190827 | Chicago Pain Medicine Center | Durable Medical Equipment & Medical Supplies | 8012 S Crandon Ave, Chicago, IL 60617-1124 | 2020-10-02 |
| 1174006217 | Advanced Imaging Services, LLC | Radiology | 8012 S Crandon Ave, Chicago, IL 60617-1124 | 2018-09-14 |
| 1649782772 | Art of Pain Co | Anesthesiology | 8012 S Crandon Ave, Chicago, IL 60617-1124 | 2017-10-30 |
| 1710406715 | Steven R. Greenwald Md Sc | Anesthesiology | 8012 S Crandon Ave, Chicago, IL 60617-1124 | 2017-09-12 |
| 1730632043 | Mount Sinai Community Foundation | Internal Medicine | 8012 S Crandon Ave, Chicago, IL 60617-1124 | 2016-08-03 |
| 1194120337 | Kathleen Powell | Registered Nurse | 8012 S Crandon Ave, Rm. 318, Chicago, IL 60617-1124 | 2014-10-30 |
| 1225479470 | South Shore Hospital Corporation | Dietitian, Registered | 8012 S Crandon Ave, Chicago, IL 60617-1124 | 2013-07-16 |
| 1689935397 | South Shore Hospital Corporation | Psychiatric Unit | 8012 S Crandon Ave, Chicago, IL 60617-1124 | 2012-05-30 |
| 1346498292 | Arpit Suresh Shah | Internal Medicine | 8012 S Crandon Ave, Suite 100, Chicago, IL 60617-1124 | 2008-09-04 |
| 1811145766 | South Shore Radiologists, S.c. | Radiology | 8012 S Crandon Ave, Chicago, IL 60617-1124 | 2008-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102921 | Manuel Lule | Physical Therapy Assistant | 9535 S Jeffery Boulevard, Chicago, IL 60617 | 2020-07-24 |
| 1083253546 | Vanaja Thotten | Internal Medicine | 8012 S.crandon Ave, Chicago, IL 60617 | 2020-01-02 |
| 1427527365 | Stony Island Dental PC | Dentist | 1600 E 93rd Street, Chicago, IL 60617 | 2018-11-21 |
| 1871060301 | Tamika Nicole Whitehead | Social Worker | 2822 East 83rd Street, Chicago, IL 60617 | 2018-11-02 |
| 1528543774 | Felicia Nwankwo | Nurse Practitioner | 2822 E 83rd Street Bradond Famiy Health Cener, Chicago, IL 60617 | 2018-10-03 |
| 1972099307 | David Phan | Optometrist | 1753 E 95th St Ste B-100, Chicago, IL 60617 | 2018-07-09 |
| 1831607340 | Pamela Evette Ewing | Counselor | 9145 S. Merrill Ave, Chicago, IL 60617 | 2018-01-18 |
| 1366976631 | Ali Mostafa Serhal | Radiology | 240 E. Huron St, Suite 1-203, Chicago, IL 60617 | 2017-04-13 |
| 1447784921 | 1915-25 95th St., LLC | Clinic/Center | 1915 E 95th St, Chicago, IL 60617 | 2017-04-12 |
| 1881140408 | Yeferson Laverde | Social Worker | 3062 East 31st, Chicago, IL 60617 | 2016-09-01 |
| Find all providers in zip 60617 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801337506 | University of Chicago Medical Center | General Acute Care Hospital | 1122 Paysphere Cir, Chicago, IL 60674-0011 | 2017-03-14 |
| 1336598937 | Daniel Benjamin Holt Jr. | General Acute Care Hospital | 2448 N Seminary Ave, Apt 2b, Chicago, IL 60614-7445 | 2016-06-06 |
| 1841650942 | Latoyia Roman | General Acute Care Hospital | 6756 S Oglesby Ave, Unit 1, Chicago, IL 60649-1316 | 2016-03-02 |
| 1306203583 | Rush University Medical Center | General Acute Care Hospital | 4536 N Greenview Ave Apt 2n, Chicago, IL 60640-5475 | 2016-01-19 |
| 1144694639 | Danielle Marie Valentino | General Acute Care Hospital | 5841 S Maryland Ave # Mc6065, Chicago, IL 60637-1443 | 2015-11-20 |
| 1467830745 | Mcgaw Medical Center of Nu | General Acute Care Hospital | 737 N Michigan Ave, Ste 1600 Nmh, Cardiovascular Imaging, Chicago, IL 60611 | 2015-05-07 |
| 1467846022 | Andres Maldonad | General Acute Care Hospital | 6019 S Ingleside Ave, Apartment 902, Chicago, IL 60637-2600 | 2015-03-22 |
| 1093117921 | Sj Termini, Dds PC | General Acute Care Hospital | 1074 W Taylor St # 207, Chicago, IL 60607-4336 | 2014-09-23 |
| 1982014841 | None | General Acute Care Hospital | 2323 W 114th St, Chicago, IL 60643-4108 | 2014-04-30 |
| 1770905804 | Esad Zisko | General Acute Care Hospital | 2441 W Farragut Ave Apt 3b, Chicago, IL 60625-2477 | 2014-01-08 |
| 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.