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ADVOCATE ILLINOIS MASONIC PHYSICIAN GROUP
NPI 1306005400
General Acute Care Hospital in Chicago, IL

Active since June 03, 2008CLIA 14D1005379 · Microscopy
4600 N RAVENSWOOD AVE, 2ND FLOOR, CHICAGO, IL 60640(773) 561-7500(773) 561-7612 Get Directions Write a Review

NPPES record last updated: June 3, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Advocate Illinois Masonic Physician Group NPPES

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

ADVOCATE ILLINOIS MASONIC PHYSICIAN GROUP (NPI 1306005400) is a healthcare organization registered as a general acute care hospital in Chicago, Illinois and active in the NPI registry since June 2008. The organization holds a CLIA Microscopy certificate valid through October 20, 2026 and lists Linda Chen, Resident, as its authorized official.

NPPES Registry Identity

NPI1306005400
Entity TypeOrganization
Primary Taxonomy282N00000X
Legal Business NameRAVENSWOOD FAMILY PRACTICE
Location Address4600 N RAVENSWOOD AVE, 2ND FLOORChicago, IL 60640-4510
Mailing Address4600 N Ravenswood Ave, 2nd FloorChicago, IL 60640-4510 · (773) 561-7500 · Fax (773) 561-7612
Phone(773) 561-7500
Fax(773) 561-7612
Organization SubpartNo
Authorized OfficialLinda ChenResident · (630) 415-6373
Enumeration DateJune 3, 2008
✔ NPI 1306005400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral Acute Care HospitalHospitals
Taxonomy Code282N00000X
License✔ Licensed in IL · 125053010
Definition

An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.

4600 N RAVENSWOOD AVE, Chicago, IL 60640
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Other Names 1

Other NameAdvocate Illinois Masonic Physician 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 for Provider-Performed Microscopy Procedures (PPMP) 14D1005379

A M G - Ravenswood Family Practice · Chicago, IL
Active · expires Oct 20, 2026
CLIA Number14D1005379
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateOctober 21, 2024
Certificate Expiration DateOctober 20, 2026
Laboratory DirectorJose Elizondo MD
Laboratory Phone(773) 295-3101
Laboratory LocationA M G - Ravenswood Family Practice4600 North Ravenswood, Chicago, IL 60640
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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.

DR. KERI LEAH FAIR M.D., PH.D.
Family Medicine
4600 N RAVENSWOOD AVE, 2ND FLOOR
CHICAGO, IL 60640
Cook County (773) 561-7500
DR. DAVID EUGENE KLEIN DO
Psychiatry & Neurology (Neurology)
4600 N RAVENSWOOD AVE
CHICAGO, IL 60640
Cook County (773) 561-7500
MEAGAN ROSE MCCORMICK DO
Family Medicine
4600 N RAVENSWOOD AVE
CHICAGO, IL 60640
Cook County (773) 561-7500
POOJA KANTHAWAR MD
Family Medicine
4600 N RAVENSWOOD AVE
CHICAGO, IL 60640
Cook County (773) 561-7500
MARIELA CANO M.D.
Family Medicine
4600 N RAVENSWOOD AVE, 2ND FLR
CHICAGO, IL 60640
Cook County (773) 561-7500
HEMISHA SANGANI DO
Family Medicine
4600 N RAVENSWOOD AVE
CHICAGO, IL 60640
Cook County (773) 561-7500
FARANAK NAJIBI M.D
Psychiatry & Neurology (Neurology)
4600 N RAVENSWOOD AVE
CHICAGO, IL 60640
Cook County (773) 561-7500
KIMBERLY ROWGHANI DO
Family Medicine
4600 N RAVENSWOOD AVE
CHICAGO, IL 60640
Cook County (773) 561-7500

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 Ravenswood Family Practice's NPI number?

The NPI number for Ravenswood Family Practice is 1306005400. It was assigned to this organization in the NPPES registry on June 3, 2008. The provider is also known as Advocate Illinois Masonic Physician Group.

Where is Ravenswood Family Practice located?

Ravenswood Family Practice is located at 4600 N Ravenswood Ave 2nd Floor, Chicago, IL 60640. The listed phone number is (773) 561-7500.

What is Ravenswood Family Practice's specialty?

The primary specialty registered for this NPI is General Acute Care Hospital with taxonomy code 282N00000X.

Does Ravenswood Family Practice hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 14D1005379) is associated with this NPI, valid through October 20, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ravenswood Family Practice was last updated on June 3, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.