CCN: 140300 NPI: 1487664561 Organization

PROVIDENT HOSPITAL OF CHICAGO

500 EAST 51ST STREET
CHICAGO, IL 606152494

Contact Information

Phone 3125721200
Fax 3125721294
Enumeration Date 2006-08-09
Last Updated 2025-05-13

Taxonomies

Code: 282N00000X (Primary) License State: IL License: 0004549

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 0.737

medicaidRatio 0.3013

uncompensatedCareAmount 31926.38

internsToBedsRatio 0.0115

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 0.737

medicaidRatio 0.3013

uncompensatedCareAmount 31926.38

internsToBedsRatio 0.0115

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 0.737

medicaidRatio 0.3013

uncompensatedCareAmount 31926.38

internsToBedsRatio 0.009

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 0.737

medicaidRatio 0.3013

uncompensatedCareAmount 32425.66

internsToBedsRatio 0.009

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.181

medicaidRatio 0.2795

uncompensatedCareAmount 32425.66

internsToBedsRatio 0.0036

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.181

medicaidRatio 0.2795

uncompensatedCareAmount 32425.66

internsToBedsRatio 0.0036

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.181

medicaidRatio 0.2795

uncompensatedCareAmount 32425.66

internsToBedsRatio 0.0036

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.181

medicaidRatio 0.2795

uncompensatedCareAmount 83366.59

internsToBedsRatio 0.0036

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 0.229

medicaidRatio 0.2251

uncompensatedCareAmount 83366.59

internsToBedsRatio 0.6201

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 0.229

medicaidRatio 0.2251

uncompensatedCareAmount 83366.59

internsToBedsRatio 0.6201

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 0.229

medicaidRatio 0.2251

uncompensatedCareAmount 83366.59

internsToBedsRatio 0.2123

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 0.24

medicaidRatio 0.2251

uncompensatedCareAmount 93286.9

internsToBedsRatio 0.2123

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 0.24

medicaidRatio 0.2604

uncompensatedCareAmount 93286.9

internsToBedsRatio 0.1866

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 0.24

medicaidRatio 0.2604

uncompensatedCareAmount 93286.9

internsToBedsRatio 0.2679

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 0.24

medicaidRatio 0.2604

uncompensatedCareAmount 93286.9

internsToBedsRatio 0.2679

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 0.227

medicaidRatio 0.2604

uncompensatedCareAmount 110916.35

internsToBedsRatio 0.2679

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.084

medicaidRatio 0.2745

uncompensatedCareAmount 110916.35

internsToBedsRatio 0.1636

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.084

medicaidRatio 0.2745

uncompensatedCareAmount 110916.35

internsToBedsRatio 0.1636

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.084

medicaidRatio 0.2745

uncompensatedCareAmount 110916.35

internsToBedsRatio 0.1636

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.084

medicaidRatio 0.2745

uncompensatedCareAmount 68342.61

internsToBedsRatio 0.1636

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.155

medicaidRatio 0.2793

uncompensatedCareAmount 68342.61

internsToBedsRatio 0.1794

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16984

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.155

medicaidRatio 0.2793

uncompensatedCareAmount 68342.61

internsToBedsRatio 0.1548

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16974

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.155

medicaidRatio 0.4475

uncompensatedCareAmount 69669.59

internsToBedsRatio 0.0987

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16974

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.155

medicaidRatio 0.4475

uncompensatedCareAmount 69669.59

internsToBedsRatio 0.0987

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16974

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.159

medicaidRatio 0.4475

uncompensatedCareAmount 69669.59

internsToBedsRatio 0.0987

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16974

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.159

medicaidRatio 0.4475

uncompensatedCareAmount 69669.59

internsToBedsRatio 0.1201

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16974

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.159

medicaidRatio 0.4475

uncompensatedCareAmount 43398.0

internsToBedsRatio 0.1201

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16974

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.159

medicaidRatio 0.4475

uncompensatedCareAmount 43398.0

internsToBedsRatio 0.1201

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16974

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.159

medicaidRatio 0.4475

uncompensatedCareAmount 43398.0

internsToBedsRatio 0.1201

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16974

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.16

medicaidRatio 0.5527

uncompensatedCareAmount 43398.0

internsToBedsRatio 0.1363

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16974

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.16

medicaidRatio 0.5527

uncompensatedCareAmount 43398.0

internsToBedsRatio 0.15

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16974

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.16

medicaidRatio 0.5527

uncompensatedCareAmount 12413.17

internsToBedsRatio 0.15

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 16974

providerType 00

caseMixIndex 0.9125

operatingCostToChargeRatio 1.183

medicaidRatio 0.5195

uncompensatedCareAmount 12413.17

internsToBedsRatio 0.15

hhrAdjustment 1.0

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 16984

providerType 00

operatingCostToChargeRatio 0.638

deviceCostToChargeRatio 0.295

specialPaymentIndicator

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16984

providerType 00

operatingCostToChargeRatio 0.638

deviceCostToChargeRatio 0.295

specialPaymentIndicator

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16984

providerType 00

operatingCostToChargeRatio 0.734

deviceCostToChargeRatio 0.373

specialPaymentIndicator

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16984

providerType 00

operatingCostToChargeRatio 0.734

deviceCostToChargeRatio 0.373

specialPaymentIndicator

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16984

providerType 00

operatingCostToChargeRatio 0.835

deviceCostToChargeRatio 0.425

specialPaymentIndicator

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16984

providerType 00

operatingCostToChargeRatio 0.835

deviceCostToChargeRatio 0.425

specialPaymentIndicator

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16984

providerType 00

operatingCostToChargeRatio 0.865

deviceCostToChargeRatio 1.0

specialPaymentIndicator

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16984

providerType 00

operatingCostToChargeRatio 0.865

deviceCostToChargeRatio 1.0

specialPaymentIndicator

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16984

providerType 00

operatingCostToChargeRatio 0.833

specialPaymentIndicator

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16984

providerType 00

operatingCostToChargeRatio 0.833

specialPaymentIndicator

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16984

providerType 00

operatingCostToChargeRatio 0.626

specialPaymentIndicator

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16974

providerType 00

operatingCostToChargeRatio 0.626

specialPaymentIndicator Y

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16974

providerType 00

operatingCostToChargeRatio 0.589

specialPaymentIndicator Y

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16974

providerType 00

operatingCostToChargeRatio 0.537

specialPaymentIndicator Y

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16974

providerType 00

operatingCostToChargeRatio 0.537

specialPaymentIndicator Y

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16974

providerType 00

operatingCostToChargeRatio 0.909

specialPaymentIndicator Y

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16974

providerType 00

operatingCostToChargeRatio 0.909

specialPaymentIndicator Y

carrierCode 06102

localityCode 16

cbsaActualGeographicLocation 16974

providerType 00

operatingCostToChargeRatio 0.706

deviceCostToChargeRatio 0.424

specialPaymentIndicator Y

carrierCode 06102

localityCode 16

PROVIDENT HOSPITAL OF CHICAGO

Contact Information

Taxonomies

Inpatient Payment Attributes (IPSF) View Dictionary →

Outpatient Payment Attributes (OPSF) View Dictionary →

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