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Organization
ADVOCATE NORTHSIDE HEALTH SYSTEM
Active
Organization
ADVOCATE NORTHSIDE HEALTH SYSTEM
Active
Other names
ADVOCATE ILLINOIS MASONIC MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
KARA RICHARDSON (VP MANAGED HEALTH)
(980) 416-4068
Entity
Organization
Contact information
Practice address
913 W WELLINGTON AVE FL 2, CHICAGO, IL 60657-6709
(873) 843-0200
Mailing address
PO BOX 70508, CHICAGO, IL 60673-0508
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
04004
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04004
—
IL
Enumeration date
09/09/2011
Last updated
04/21/2026
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