JESSE BROWN VETERANS ADMINISTRATION HOSPITAL
NPI 1679561260
General Acute Care Hospital - Critical Access in Chicago, IL
NPI Status: Active since October 09, 2005
Contact Information
820 S DAMEN AVE
CHICAGO, IL
ZIP 60612
Phone: (312) 569-6123
Fax: (312) 569-8102
- Organization
- General Acute Care Hospital
- Critical Access
- CLIA Number: 14D0988057
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 05-22-2026
About JESSE BROWN VETERANS ADMINISTRATION HOSPITAL
This page provides the complete NPI Profile along with additional information for Jesse Brown Veterans Administration Hospital, a provider established in Chicago, Illinois operating as a General Acute Care Hospital, focusing in critical access . The healthcare provider is registered in the NPI registry with number 1679561260 assigned on October 2005. The practitioner's primary taxonomy code is 282NC0060X with license number 036066117 (IL). The provider is registered as an organization and their NPI record was last updated 17 years ago. The authorized official of this NPI record is Dr. Farida Ahmed M.d. (Staff Radiologist)
- NPI
- 1679561260
- Provider Name
- JESSE BROWN VETERANS ADMINISTRATION HOSPITAL
- Entity Type
- Organization
- Location Address
- 820 S DAMEN AVE CHICAGO, IL 60612
- Location Phone
- (312) 569-6123
- Location Fax
- (312) 569-8102
- Mailing Address
- 950 N CLARK ST UNIT K., CHICAGO, IL 60610
- Mailing Phone
- (312) 280-1840
- Mailing Fax
- (312) 569-8102
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-09-2005
- Last Update Date
- 07-21-2008
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
General Acute Care Hospital Critical Access
- Taxonomy Code
- 282NC0060X
- Type
- Hospitals
- License No.
- 036066117
- License State
- IL
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D0988057
- Facility Type
- Hospital
- Certificate Effective Date
- June 19, 2001
- Certificate Expiration Date
- May 22, 2026
- Laboratory Director
- SHOUJIN WU
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Jesse Brown Veterans Administration Hospital on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 7 | 9 | 5 | 6 | 1 | 2 | 6 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 14 | 9 | 10 | 6 | 2 | 2 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 1 + 4 + 9 + 1 + 0 + 6 + 2 + 2 + 1 + 2 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1679561260 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1972582179 | MRS. MILA L ALBERT PHARM.D Individual | Pharmacist | 820 S DAMEN AVE CHICAGO, IL 60612 (312) 569-7174 |
| 1619944931 | LEWIS RUSSELL COULSON M.D. Individual | Internal Medicine | 820 S DAMEN AVE CHICAGO, IL 60612 (312) 569-6260 |
| 1194792325 | MRS. MARY JANE TOLES APN Individual | Nurse Practitioner | 820 S DAMEN AVE CHICAGO, IL 60612 (312) 569-6354 |
| 1801864806 | MS. MARY ANNE DIGNAN CNS Individual | Clinical Nurse Specialist (Critical Care Medicine) | 820 S DAMEN AVE ROOM 4230 CHICAGO, IL 60612 (312) 569-7895 |
| 1730156779 | MS. ELIZABETH ANN BOHLING NP-C Individual | Nurse Practitioner (Adult Health) | 820 S DAMEN AVE MC 118 CHICAGO, IL 60612 (312) 569-6366 |
| 1700853769 | DEBRA MARIE PATER APN, BC Individual | Registered Nurse (Psychiatric/Mental Health, Adult) | 820 S DAMEN AVE CHICAGO, IL 60612 (312) 569-7217 |
| 1528037686 | MS. LYNNE O'DONNELL APN-BC Individual | Nurse Practitioner | 820 S DAMEN AVE #118 CHICAGO, IL 60612 (312) 569-7842 |
| 1558330696 | MISS CLARA LA VERNE ARMSTRONG RN, NP Individual | Nurse Practitioner (Adult Health) | 820 S DAMEN AVE CHICAGO, IL 60612 (312) 569-8387 |
| 1568431344 | MS. JENNY ANN O'DONOHUE NP Individual | Nurse Practitioner | 820 S DAMEN AVE NURSING-118 CHICAGO, IL 60612 (312) 569-8387 |
| 1457320053 | MRS. BARBARA ALLEN WILLARD RN, CNS Individual | Registered Nurse (Psychiatric/Mental Health, Adult) | 820 S DAMEN AVE CHICAGO, IL 60612 (312) 569-7206 |
| 1578532198 | JAN L WILTSIE NP Individual | Nurse Practitioner | 820 S DAMEN AVE EMPLOYEE HEALTH CHICAGO, IL 60612 (312) 569-7159 |
| 1144289083 | MS. GWENDOLYN HARRIS CRNA Individual | Nurse Anesthetist, Certified Registered | 820 S DAMEN AVE DEPT OF ANESTHESIA CHICAGO, IL 60612 (312) 560-6126 |
| 1821051228 | ROBERT WILLIAM KLOTH CRNA Individual | Registered Nurse | 820 S DAMEN AVE CHICAGO, IL 60612 (312) 569-8387 |
| 1740243997 | KAREN K DAVIS NP Individual | Nurse Practitioner (Family) | 820 S DAMEN AVE JBVAMC (11F) CHICAGO, IL 60612 (312) 569-7369 |
| 1124077854 | DR. SUNALI PATEL SINGH M.D. Individual | Family Medicine (Adult Medicine) | 820 S DAMEN AVE CHICAGO, IL 60612 (312) 569-6218 |
| 1457300121 | DR. MARIAN FITZGIBBON PH.D. Individual | Psychologist (Clinical) | 820 S DAMEN AVE CHICAGO, IL 60612 (312) 996-0146 |
| 1033161252 | MS. ESTHERLYN MAYMON MPA, OTR/L Individual | Occupational Therapist (Neurorehabilitation) | 820 S DAMEN AVE PM&R #117 CHICAGO, IL 60612 (312) 569-7956 |
| 1083667158 | MICHELLE MARIE MARCINIAK O.D. Individual | Optometrist | 820 S DAMEN AVE JESSE BROWN VAMC, 170-F CHICAGO, IL 60612 (312) 569-7501 |
| 1942254966 | DR. KUN YAN M.D. Individual | Physical Medicine & Rehabilitation | 820 S DAMEN AVE M/C 117, PM&R CHICAGO, IL 60612 (312) 569-6383 |
| 1083668925 | NUTTHINEE WONGVIBULSIN Individual | Physical Therapist | 820 S DAMEN AVE CHICAGO, IL 60612 (312) 569-6375 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1679561260, enumerated in the NPI registry as an "organization" on October 09, 2005
The provider is located at 820 S Damen Ave Chicago, Il 60612 and the phone number is (312) 569-6123
This medical organization specializes in General Acute Care Hospital with taxonomy code 282NC0060X with a focus in Critical Access
The provider's CLIA number is 14D0988057 for a "hospital" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on October 09, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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