MARYVILLE ACADEMY


Address: 1510 N Claremont Ave, Chicago, IL 60622-1710
Phone: 3124913509

MARYVILLE ACADEMY (NPI# 1366957292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366957292
Entity Type Organization
Organization Name MARYVILLE ACADEMY
Other Organization Name FAMILY BEHAVIORAL HEALTH CLINIC
Practice Address 1510 N Claremont Ave
Chicago
IL 60622-1710
Mailing Address 1455 E Golf Rd Ste 210
Des Plaines
IL 60016-1254
Practice Telephone 3124913509
Practice Fax Number 3123913531
Mailing Telephone 8473903004
Mailing Fax Number 8473903016
Enumeration Date 2017-12-14
Last Update Date 2017-12-14
Authorized Official Name NANCY Z WOULFE (DIRECTOR OF BUSINESS DEVELOPMENT)
Authorized Official Telephone 8472941910
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Family Behavioral Health Clinic Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1487072781 Maryville Academy Clinic/Center 1455 E Golf Rd Ste 210, Des Plaines, IL 60016-1254 2014-04-03
1508174749 Maryville Academy Community Based Residential Treatment Facility, Mental Illness 1658 W Grand Ave, Chicago, IL 60622-6309 2010-09-22
1275771214 Maryville Academy Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 951 W Bartlett Rd, Bartlett, IL 60103-4479 2009-01-29
1477700474 Maryville Academy Residential Treatment Facility, Emotionally Disturbed Children 10102 Farm School Rd, Durand, IL 61024-9725 2008-08-20
1578720041 Maryville Academy Long Term Care Hospital 4015 N Oak Park Ave Bldg B, Chicago, IL 60634-7197 2008-05-21
1578697835 Maryville Academy Community/Behavioral Health 1150 N River Rd, Des Plaines, IL 60016-1214 2007-03-16
1306873419 Maryville Academy Psychiatric Residential Treatment Facility 555 Wilson Lane, Maryville Scott Nolan Center, Des Plaines, IL 60016-4729 2006-06-26
1821504788 Maryville Academy Clinic/Center 1510 N Claremont Ave, Chicago, IL 60622-1710 2017-12-14
1487189445 Maryville Academy Clinic/Center 951 W Bartlett Rd, Bartlett, IL 60103-4479 2017-04-27
1003341058 Maryville Academy Clinic/Center 1658 W Grand Ave, Chicago, IL 60622-6309 2017-04-27

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities MARYVILLE ACADEMY 1150 N River Rd, Des Plaines, IL 60016-1214

Office Location

Street Address 1510 N CLAREMONT AVE
City CHICAGO
State IL
Zip Code 60622-1710

Providers in the same location

NPI Name Taxonomy Address Enumeration
1821504788 Maryville Academy Clinic/Center 1510 N Claremont Ave, Chicago, IL 60622-1710 2017-12-14

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1447880471 Erikson Institute Clinic/Center 2739 W Division St, Chicago, IL 60622 2020-01-17
1720620545 Emily Claire Bonanno Counselor 1397 N Miwaukee Ave, Chicago, IL 60622 2019-10-14
1891342093 Taylor Mallon Speech-Language Pathologist 8870 South Duffy Avenue, Apartment 406, Chicago, IL 60622 2019-08-22
1083260277 Maggie Inman Student in an Organized Health Care Education/Training Program 1431 N Claremont Avenue, 2nd Floor Pavilion, Chicago, IL 60622 2019-08-13
1174176168 Karol Maricel Quelal Analuisa Internal Medicine 1901 W Harrison, Chicago Il 60612-3714, Chicago, IL 60622 2019-07-19
1073076105 Nichole Galullo Social Worker 1431 N Claremont 2nd Floor, Chicago, IL 60622 2019-04-06
1003375122 Alfredo Delgado Perez Sr. Psychologist 1127 N Oakley Bvl 3 Floor, Chicago, IL 60622 2019-03-18
1841773439 Abigail Hector Counselor 1521 N Milwaukee Ave, 3n, Chicago, IL 60622 2018-09-11
1164916144 Dorothy Mitkowski Student in an Organized Health Care Education/Training Program 1127 N. Oakley Blvd., 2nd Floor, Chicago, IL 60622 2018-06-21
1255825121 Kara Lynn Daniel Speech-Language Pathologist 1540 N Artesian Ave Apt 2r, Chicago, IL 60622 2018-06-14
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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144852260 Vincent Wallace Clinic/Center 226 W Ontario St, Chicago, IL 60654-3619 2020-02-06
1053957993 Safer Foundation Clinic/Center 769 W Jackson, Unit G, Chicago, IL 60661 2019-11-26
1255977195 Safer Foundation Clinic/Center 6352 W Grand Ave, Chicago, IL 60639-2650 2019-11-26
1063068492 The Threshold Clinic/Center 3015 W Harrison St, Chicago, IL 60612 2019-08-12
1790338150 Solleys House Clinic/Center 4163 S Archer Ave, Chicago, IL 60632-1870 2019-07-24
1366925489 Lurie Children's Adolescent Substance Abuse and Prevention Progarm Clinic/Center 1440 N Dayton St, Chicago, IL 60642-2644 2018-09-13
1710482815 Gateway Foundation, Inc. Clinic/Center 415 N Dearborn St Ste 510, Chicago, IL 60654-4626 2018-03-29
1053836395 Aunt Martha's Health and Wellness, Inc. Clinic/Center 5001 S Michigan Ave Ste B, Chicago, IL 60615-2112 2017-08-08
1437679255 Sixto Garcia Clinic/Center 1100 W. Cermak Rd, Chicago, IL 60608 2017-06-22
1265979694 Renewed Hope Community Services Clinic/Center 618 E 71st St, Chicago, IL 60619-1244 2017-01-24
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Competitor

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City CHICAGO
Zip Code 60622

Improve Information

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Dataset Information

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.

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