MARYVILLE ACADEMY (NPI# 1487072781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487072781 |
| Entity Type | Organization |
| Organization Name | MARYVILLE ACADEMY |
| Other Organization Name | FAMILY BEHAVIORAL HEALTH CLINIC |
| Practice Address |
1455 E Golf Rd Ste 210 Des Plaines IL 60016-1254 |
| Mailing Address |
1150 N River Rd Des Plaines IL 60016-1214 |
| Practice Telephone | 8473903004 |
| Practice Fax Number | 8473903016 |
| Mailing Telephone | 8472941999 |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2018-11-08 |
| Authorized Official Name | SR. CATHERINE M RYAN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8472941893 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Family Behavioral Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366957292 | Maryville Academy | Clinic/Center | 1510 N Claremont Ave, Chicago, IL 60622-1710 | 2017-12-14 |
| 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 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MARYVILLE ACADEMY | 1150 N River Rd, Des Plaines, IL 60016-1214 |
| Street Address |
1455 E GOLF RD STE 210 |
| City | DES PLAINES |
| State | IL |
| Zip Code | 60016-1254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467909275 | Maryville Academy | Clinic/Center | 1455 E Golf Rd Ste 210, Des Plaines, IL 60016-1254 | 2016-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043702830 | Professional Healthcare Inc | Family Medicine | 960 Rand Rd Ste 224, Des Plaines, IL 60016 | 2018-06-06 |
| 1407367022 | Vcare Pharmacy Inc | Pharmacy | 380 E Nortwest Hwy, Suite 201, Des Plaines, IL 60016 | 2017-10-23 |
| 1649799610 | George N Hotousiotis | Pharmacist | 10 East Golf Road, Des Plaines, IL 60016 | 2017-09-11 |
| 1619494838 | Abdul M Shamsuddin | Physical Therapist | 2555 Suffield St, Des Plaines, IL 60016 | 2017-08-28 |
| 1063960482 | Rachel Kimbrough | Counselor | 100 N River Road, Des Plaines, IL 60016 | 2016-09-14 |
| 1902250178 | Perfect Storm Chiropractic, LLC | Chiropractor | 565 Concord Ln, Des Plaines, IL 60016 | 2016-04-14 |
| 1255796611 | Nektaria Goudis | Psychologist | 950 Lee Street, Des Plaines, IL 60016 | 2015-12-29 |
| 1831501352 | Gary R. Kuntz | Dentist | 1173 Algonquin Rd., Des Plaines, IL 60016 | 2014-06-02 |
| 1558773754 | Midwest Anesthesia and Pain Specialists, Sc | Pain Medicine | 9700 Golf Rd, Second Floor, Des Plaines, IL 60016 | 2014-05-22 |
| 1508282377 | Maciej Padowski | Emergency Medicine | 9500 Greenwood Dr, Des Plaines, IL 60016 | 2014-03-17 |
| Find all providers in zip 60016 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578082020 | Rosecrance Inc. | Clinic/Center | 701 Lee St, Des Plaines, IL 60016-4539 | 2017-09-15 |
| 1457413882 | Family Guidance Centers, Inc. | Clinic/Center | 484 Lee St, Des Plaines, IL 60016-4610 | 2006-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689273153 | Navis Health LLC | Clinic/Center | 2602 Rolling Acres Dr, Champaign, IL 61822-7240 | 2020-10-25 |
| 1164036661 | Existential Counselor Societ Ltd. | Clinic/Center | 1225 Richards St, Joliet, IL 60433-2745 | 2020-09-02 |
| 1457964934 | Rosecrance Inc | Clinic/Center | 15 N Galena Ave, Freeport, IL 61032-4348 | 2020-08-25 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1174148167 | Associates In Behavioral Health Care | Clinic/Center | 910 Lake St Ste 102, Roselle, IL 60172-3384 | 2020-06-15 |
| 1538784533 | Associates In Behavioral Health Care | Clinic/Center | 1375 E Schaumburg Rd Ste 120, Schaumburg, IL 60194-3643 | 2020-06-15 |
| 1265056964 | Gateway Foundation, Inc. | Clinic/Center | 3040 Finley Rd, Downers Grove, IL 60515-5713 | 2020-05-29 |
| 1922634021 | Lutheran Social Services of Illinois | Clinic/Center | 400 N Cherry St, Morrison, IL 61270-2605 | 2020-03-20 |
| 1144852260 | Vincent Wallace | Clinic/Center | 226 W Ontario St, Chicago, IL 60654-3619 | 2020-02-06 |
| 1093354037 | A Bridge Back, Inc. | Clinic/Center | 314 Mchenry Rd, Buffalo Grove, IL 60089-2428 | 2019-12-21 |
| Find all providers with the same taxonomy | ||||
| City | DES PLAINES |
| Zip Code | 60016 |
Please comment or provide details below to improve the information on MARYVILLE ACADEMY.
| 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.