Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Roseland Community Hospital Association

Organization Addiction Medicine (Psychiatry & Neurology) Physician · NPI 1568472819

Roseland Community Hospital Association is an Addiction Medicine (Psychiatry & Neurology) Physician in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
Specialties on file
5

Practice location Address checks out

45 W 111th St
Chicago, IL 60628-4200
Phone: (773) 995-3000
Fax: (773) 995-6602
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Acute Care Hospital (primary) Taxonomy 282N00000X · Licence 0002063 (IL)
Addiction Medicine (Psychiatry & Neurology) Physician Taxonomy 2084A0401X
Psychiatric Hospital Unit Taxonomy 273R00000X · Licence 0002063 (IL)
Psychiatric Hospital Taxonomy 283Q00000X · Licence 0002063 (IL)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X · Licence 0002063 (IL)

Record details

NPI number1568472819
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tim Egan — Ceo · (773) 995-3000
Other names Roseland Community Hospital; Roseland Community Hospital
NPI enumeratedAugust 9, 2006
Last updated in NPPESNovember 27, 2023
Mailing address45 W 111th St, Chicago, IL 60628-4200

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