# ADVOCATE ILLINOIS MASONICMEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ADVOCATE HEALTHCARE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1134395155
- **Legal business name:** ADVOCATE HEALTHCARE
- **Authorized official:** DR. TERESA RAMOS M.D. (RESIDENCY PROGRAM DIRECTOR)
- **Authorized official phone:** (773) 296-7046

## Contact information

- **Practice address:** 3048 N WILTON AVE, 2ND FLOOR, CHICAGO, IL 60657-6710
- **Practice address phone:** (773) 296-5424
- **Practice address fax:** (773) 296-5280
- **Mailing address:** 836 W WELLINGTON AVE, ROOM 7403, CHICAGO, IL 60657-5147

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 125-052303 | IL | Yes |

## Other

- **Enumeration date:** 04/30/2008
- **Last updated:** 04/30/2008