PSYCHIATRY SPECIALISTS (NPI# 1003172404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003172404 |
| Entity Type | Organization |
| Organization Name | PSYCHIATRY SPECIALISTS |
| Practice Address |
855 W 103rd St Suite 100 Chicago IL 60643-2357 |
| Mailing Address |
4535 N Beacon St Chicago IL 60640-5518 |
| Practice Telephone | 7732399600 |
| Mailing Telephone | 7732399600 |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-10 |
| Authorized Official Name | MS. ANGELA RATCLIFFE (OFFICER) |
| Authorized Official Telephone | 7732399600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
036121844 | IL | Ambulatory Health Care Facilities |
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
036121844 | IL | Ambulatory Health Care Facilities |
| Y | 251S00000X | Community/Behavioral Health | 036121844 | IL | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036121844 | 05 |
| Street Address |
855 W 103RD ST SUITE 100 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60643-2357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437407517 | Jessie L Mabaquiao Md | Psychiatry & Neurology | 855 W 103rd St, Suite 100, Chicago, IL 60643-2357 | 2012-08-21 |
| 1669730107 | Qun Wu Md | Clinic/Center | 855 W 103rd St, 100, Chicago, IL 60643-2357 | 2012-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154941698 | Breann Hampton | Behavior Technician | 1214 W 115th St, Chicago, IL 60643 | 2020-04-24 |
| 1366075566 | Sanctuary Counseling, LLC | Home Health | 12247 S Racine Ave, Calumet Park, IL 60643 | 2020-02-16 |
| 1467082883 | Juliana Frances Cunningham | Developmental Therapist | 10037 S Bell, Chicago, IL 60643 | 2020-01-24 |
| 1013578624 | Sct Counseling | Counselor | 11948 S Western Ave, Chicago, IL 60643 | 2019-06-25 |
| 1073087474 | For Eyes Optical Company of Pa | Optometrist | 9900 S Ridgleland Ave, Chicago Ridge, IL 60643 | 2019-01-18 |
| 1073096426 | Derek Peake | Physical Therapist | 9465 S. Western Road, Chicago, IL 60643 | 2018-09-12 |
| 1508356072 | Halo Medical Professionals Sc. | Chiropractor | 10650 S Western Ave, Chicago, IL 60643 | 2018-05-10 |
| 1811405699 | Kara Eileen Noland | Developmental Therapist | 9327 S Hamilton Ave, Chicago, IL 60643 | 2018-01-16 |
| 1588173546 | Kiah Nicole Bouie | Behavioral Analyst | 1461 W 113th Pl, Chicago, IL 60643 | 2017-09-21 |
| 1174042766 | Travis Wade Robertson | Physical Therapist | 10909-11 S Western Ave, Beverly, IL 60643 | 2017-09-14 |
| Find all providers in zip 60643 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336753896 | Counseling Kennedy Shenberg | Community/Behavioral Health | 5752 N Campbell Ave Apt 1, Chicago, IL 60659-5080 | 2020-09-02 |
| 1700498573 | Bobby E. Wright Comprehensive Behavioral Health Center, Inc. | Community/Behavioral Health | 5816 W Division St Fl 1, Chicago, IL 60651-1003 | 2020-08-21 |
| 1164030557 | Acorn & Oak Counseling Pllc | Community/Behavioral Health | 1333 W Devon Ave Ste 319, Chicago, IL 60660-1329 | 2020-07-21 |
| 1144848300 | Marathon Mindset Counseling LLC | Community/Behavioral Health | 1650 W Adams St Apt 304, Chicago, IL 60612-3209 | 2020-07-13 |
| 1417586678 | Invisions Behavioral Health LLC | Community/Behavioral Health | 8211 S Woodlawn Ave, Chicago, IL 60619-4519 | 2020-04-08 |
| 1871124784 | Nurture Therapy, LLC | Community/Behavioral Health | 3711 N Ravenswood Ave Ste 146, Chicago, IL 60613-5944 | 2020-01-29 |
| 1962032086 | Bucktown Therapy | Community/Behavioral Health | 1820 W Webster Ave Ste 200, Chicago, IL 60614-2934 | 2020-01-16 |
| 1770121436 | Guided Expressions LLC | Community/Behavioral Health | 6640 S University Ave Apt 2, Chicago, IL 60637-4320 | 2019-12-12 |
| 1063058279 | Y Not Families | Community/Behavioral Health | 6427 S Ashland Ave, Chicago, IL 60636-2716 | 2019-11-22 |
| 1073156196 | Black Tie Therapy | Community/Behavioral Health | 2232 N Wayne Ave Apt 1f, Chicago, IL 60614-8937 | 2019-10-21 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.