SAINT ANTHONY HEALTH AFFILIATES (NPI# 1912397480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912397480 |
| Entity Type | Organization |
| Organization Name | SAINT ANTHONY HEALTH AFFILIATES |
| Other Organization Name | KEDZIE CLINIC |
| Practice Address |
4455 S Kedzie Ave Chicago IL 60632-2814 |
| Mailing Address |
Po Box 83 Crown Point IN 46308-0083 |
| Practice Telephone | 7735230400 |
| Practice Fax Number | 7735232725 |
| Mailing Telephone | 7734844783 |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2020-04-20 |
| Authorized Official Name | GUY MEDAGLIA (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 7734844783 |
| Is Organization Subpart | Y |
| Parent Organization Name | SAINT ANTHONY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Kedzie Clinic | Other Name - Individual/Organization |
| SAH Community Care Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295010056 | Saint Anthony Health Affiliates | Clinic/Center | 2875 West 19th Street, Chicago, IL 60623-3501 | 2011-10-12 |
| 1295757771 | Saint Anthony Health Affiliates | Social Worker | 4177 South Archer Avenue, Chicago, IL 60632-1849 | 2006-07-24 |
| 1922025709 | Saint Anthony Health Affiliates | Clinic/Center | 2645 W 51st St, Chicago, IL 60632-1559 | 2006-07-16 |
| 1659985661 | Saint Anthony Health Affiliates | Clinic/Center | 30 N Michigan Ave, Chicago, IL 60602-3402 | 2020-09-08 |
| 1538655949 | Saint Anthony Health Affiliates | Clinic/Center | 1600 W 13th St, Chicago, IL 60608-1304 | 2018-07-09 |
| 1376079517 | Saint Anthony Health Affiliates | Clinic/Center | 4455 S Kedzie Ave, Chicago, IL 60632-2814 | 2017-05-09 |
| 1154713980 | Saint Anthony Health Affiliates | Clinic/Center | 3059 W 26th St, Chicago, IL 60623-4131 | 2015-03-03 |
| 1881086064 | Saint Anthony Health Affiliates | Clinic/Center | 2001 S California Ave, Chicago, IL 60608-2486 | 2015-02-25 |
| 1023453750 | Saint Anthony Health Affiliates | Anesthesiology | 2875 W 19th St, Chicago, IL 60623-3501 | 2013-05-08 |
| 1902825292 | Saint Anthony Health Affiliates | Clinic/Center | 6545 Cermak Rd, Berwyn, IL 60402-2313 | 2006-07-18 |
| Street Address |
4455 S KEDZIE AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60632-2814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871571661 | Candace Nowak | Family Medicine | 4455 S Kedzie Ave, Chicago, IL 60632-2814 | 2006-01-03 |
| 1851850820 | Taylor Powell | Physical Therapist | 4455 S Kedzie Ave, Chicago, IL 60632-2814 | 2019-03-18 |
| 1285193920 | Anna Catherine Balling | Physical Therapist | 4455 S Kedzie Ave, Chicago, IL 60632-2814 | 2019-03-12 |
| 1528558681 | Hannah Pugh | Occupational Therapist | 4455 S Kedzie Ave, Chicago, IL 60632-2814 | 2018-05-15 |
| 1427551803 | Carlos A Garcia | Physical Therapist | 4455 S Kedzie Ave, Chicago, IL 60632-2814 | 2018-03-13 |
| 1376079517 | Saint Anthony Health Affiliates | Clinic/Center | 4455 S Kedzie Ave, Chicago, IL 60632-2814 | 2017-05-09 |
| 1710378435 | Elizabeth Weamer | Physical Therapist | 4455 S Kedzie Ave, Chicago, IL 60632-2814 | 2015-02-17 |
| 1992817191 | A. K. Mathew | Internal Medicine | 4455 S Kedzie Ave, Chicago, IL 60632-2814 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104474790 | Amanda Rose Dirnberger | Nurse Practitioner | 3229-43 W. 47th Pl., Chicago, IL 60632 | 2019-08-28 |
| 1982121042 | Brown Archer Dental PC | Dentist | 4893 S Archer Ave, Chicago, IL 60632 | 2017-08-29 |
| 1538577085 | Metrosmiles - Archer Heights Dental | Dentist | 5141 S Cicero Ave, Chicago, IL 60632 | 2014-07-29 |
| 1174955173 | Thresholds | Community/Behavioral Health | 718-24 West 47th St, Chicago, IL 60632 | 2013-08-01 |
| 1659612570 | Sapex Home Healthcare, Inc. | In Home Supportive Care | 4107 West 47th Street, Chicago, IL 60632 | 2013-03-04 |
| 1912275462 | Dawn Marie Mackessy | Pharmacist | 5435 S. Kedzie Ave, Chicago, IL 60632 | 2011-12-12 |
| 1033494752 | Molly Elizabeth Mcdermott | Pharmacist | District 222-walgreens, Chicago, IL 60632 | 2011-10-13 |
| 1780908434 | Chicago Electrical Trauma Research Institute | Specialist/Technologist, Other | 4047 W. 40th Street, Chicago, IL 60632 | 2010-03-24 |
| 1265765218 | 4365 Archer Mri, LLC | Clinic/Center | 4365 South Archer Avenue, Chicago, IL 60632 | 2009-09-09 |
| 1295968121 | Smile Lee Faces | Dentist | 4197 S Archer Ave, Chicago, IL 60632 | 2009-08-26 |
| Find all providers in zip 60632 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453236 | Dirsi, Inc | Clinic/Center | 2112 N Dayton St, Chicago, IL 60614-4302 | 2020-10-05 |
| 1588261770 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 2701 W 68th St Fl 3, Chicago, IL 60629-1813 | 2020-10-01 |
| 1013514298 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 1500 S Fairfield Ave Fl 4, Chicago, IL 60608-1782 | 2020-10-01 |
| 1841804879 | Chicago Poly Clinic LLC | Clinic/Center | 2446 W Devon Ave, Chicago, IL 60659-1913 | 2020-09-08 |
| 1386258226 | Ortho Spine Surgical LLC | Clinic/Center | 1925 E 95th St Ste 220, Chicago, IL 60617-4710 | 2020-09-08 |
| 1649817768 | Rising Root Nutrition LLC | Clinic/Center | 2835 N Sheffield Ave Ste 511, Chicago, IL 60657-5081 | 2019-12-09 |
| 1487203642 | Jennifer Scherbauer | Clinic/Center | 4036 N Ashland Ave Apt 1w, Chicago, IL 60613-2534 | 2019-09-10 |
| 1194380147 | Colmed Clinic Ltd | Clinic/Center | 3615 N Ashland Ave Apt 1n, Chicago, IL 60613-4742 | 2019-05-06 |
| 1831662931 | Ova Institute LLC | Clinic/Center | 401 N Michigan Ave Ste 1800, Chicago, IL 60611-4225 | 2019-01-10 |
| 1972080992 | Family Care Sc | Clinic/Center | 2320 W Peterson Ave Fl 6, Chicago, IL 60659-5242 | 2018-07-23 |
| 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.