MARYVILLE ACADEMY


Address: 1658 W Grand Ave, Chicago, IL 60622-6309
Phone: 3124913500

MARYVILLE ACADEMY (NPI# 1508174749) 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) 1508174749
Entity Type Organization
Organization Name MARYVILLE ACADEMY
Other Organization Name MARYVILLE MADDEN SHELTER
Practice Address 1658 W Grand Ave
Chicago
IL 60622-6309
Mailing Address 1150 N River Rd
Des Plaines
IL 60016-1214
Practice Telephone 3124913500
Mailing Telephone 8472941999
Mailing Fax Number 8472942892
Enumeration Date 2010-09-22
Last Update Date 2012-01-24
Authorized Official Name MR. NORMAN JOYCE (DIRECTOR OF FINANCIAL SERVICES)
Authorized Official Telephone 8472941944
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320800000X Community Based Residential Treatment Facility, Mental Illness Residential Treatment Facilities

Other Provider/Organization Names

Other Name Type Code
Maryville Madden Shelter Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1366957292 Maryville Academy Clinic/Center 1510 N Claremont Ave, Chicago, IL 60622-1710 2017-12-14
1487072781 Maryville Academy Clinic/Center 1455 E Golf Rd Ste 210, Des Plaines, IL 60016-1254 2014-04-03
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 1658 W GRAND AVE
City CHICAGO
State IL
Zip Code 60622-6309

Providers in the same location

NPI Name Taxonomy Address Enumeration
1003341058 Maryville Academy Clinic/Center 1658 W Grand Ave, Chicago, IL 60622-6309 2017-04-27
1902353782 Maryville Academy Clinic/Center 1658 W Grand Ave, Chicago, IL 60622-6309 2016-09-08

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 320800000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment Facility, Mental Illness

Taxonomy Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1245851690 Brown Health Care Solutions LLC Community Based Residential Treatment Facility, Mental Illness 7330 S Blackstone Ave, Chicago, IL 60619-2150 2020-04-27
1376187617 Haven Pointe L3c Community Based Residential Treatment Facility, Mental Illness 4056 W 115th St Apt 100, Chicago, IL 60655-4333 2019-10-30
1093209264 Lester & Rosalie Anixter Center Community Based Residential Treatment Facility, Mental Illness 5108 W Roscoe St, Chicago, IL 60641-4204 2018-06-20
1376839274 Community Mental Health Council, Inc. Community Based Residential Treatment Facility, Mental Illness 2443 E 77th St, Chicago, IL 60649-4730 2011-06-20
1821384736 Community Mental Health Council, Inc. Community Based Residential Treatment Facility, Mental Illness 7919 S Essex Ave, Chicago, IL 60617-1213 2011-06-20
1669768560 Community Mental Health Council, Inc. Community Based Residential Treatment Facility, Mental Illness 8006 S Essex Ave, Chicago, IL 60617-1221 2011-06-20
1427344332 Community Mental Health Council, Inc Community Based Residential Treatment Facility, Mental Illness 7131 S Western Ave, Chicago, IL 60636-3614 2011-06-20
1831485739 Community Mental Health Council, Inc Community Based Residential Treatment Facility, Mental Illness 7133 S Western Ave, Chicago, IL 60636-3614 2011-06-20
1639465545 Community Mental Health Council, Inc Community Based Residential Treatment Facility, Mental Illness 7701 S Phillips Ave, Chicago, IL 60649-4705 2011-06-20
1265727614 Community Mental Health Council, Inc Community Based Residential Treatment Facility, Mental Illness 7623 S Essex Ave, Chicago, IL 60649-4037 2011-06-14
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Competitor

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City CHICAGO
Zip Code 60622

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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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