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ROSELAND COMMUNITY HOSPITAL ASSOCIATION
NPI 1265997142
Dentist - General Practice in Chicago, IL

Active since February 05, 2019CLIA 14D0699573 · Accreditation
45 W 111TH ST, CHICAGO, IL 60628(773) 995-3000(773) 995-0664 Get Directions Write a Review

NPPES record last updated: February 5, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Roseland Community Hospital Association NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROSELAND COMMUNITY HOSPITAL ASSOCIATION (NPI 1265997142) is a healthcare organization registered as a general practice in Chicago, Illinois and active in the NPI registry since February 2019. The organization holds an CLIA Accreditation certificate valid through July 26, 2027 and lists Robert Vais, Cfo, as its authorized official.

NPPES Registry Identity

NPI1265997142
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameROSELAND COMMUNITY HOSPITAL ASSOCIATION
Location Address45 W 111TH STChicago, IL 60628-4200
Mailing Address45 W 111th StChicago, IL 60628-4200 · (773) 995-3000 · Fax (773) 995-0664
Phone(773) 995-3000
Fax(773) 995-0664
Organization SubpartNo
Authorized OfficialRobert VaisCfo · (773) 995-3044
Enumeration DateFebruary 5, 2019
✔ NPI 1265997142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
45 W 111TH ST, Chicago, IL 60628
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Other Names 1

Other NameRoseland Community Hospital Dental Program

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 14D0699573

Roseland Community Hospital · Chicago, IL
Active · expires Jul 26, 2027
CLIA Number14D0699573
Laboratory TypeHospital
Certificate Effective DateJuly 27, 2025
Certificate Expiration DateJuly 26, 2027
Laboratory DirectorSamer Dola
Laboratory Phone(773) 995-3149
Laboratory LocationRoseland Community Hospital45 W 111th St, Chicago, IL 60628
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHAKIRA AYANLAJA APN
Nurse Practitioner (Family)
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3195
JUPITER JANELLE JONES FNP
Nurse Practitioner (Family)
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3000
NEW ROSE HEALTHCARE MANAGEMENT LLC
Emergency Medicine
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3000
JOY B WEST MD SC
Obstetrics & Gynecology
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3000
MADHUPA SUD MD SC
Pediatrics
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3460
MRS. BRENDA BEBEN RD
Dietitian, Registered
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3234
TIARA THOMPSON NURSE PRACTITIONER
Nurse Practitioner (Family)
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3000
DR. ALEXANDRA ISA ASROW M.D.
Emergency Medicine
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roseland Community Hospital Association's NPI number?

The NPI number for Roseland Community Hospital Association is 1265997142. It was assigned to this organization in the NPPES registry on February 5, 2019. The provider is also known as Roseland Community Hospital Dental Program.

Where is Roseland Community Hospital Association located?

Roseland Community Hospital Association is located at 45 W 111th St, Chicago, IL 60628. The listed phone number is (773) 995-3000.

What is Roseland Community Hospital Association's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Does Roseland Community Hospital Association hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 14D0699573) is associated with this NPI, valid through July 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Roseland Community Hospital Association was last updated on February 5, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.