OAK BROOK CLINIC, LLC (NPI# 1508492745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508492745 |
| Entity Type | Organization |
| Organization Name | OAK BROOK CLINIC, LLC |
| Practice Address |
2605 W 22nd St Ste 29 Oak Brook IL 60523-4625 |
| Practice Telephone | 6308198100 |
| Practice Fax Number | 6305683362 |
| Mailing Telephone | 6308198100 |
| Mailing Fax Number | 6305683362 |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2020-04-03 |
| Authorized Official Name | JIM P WEISS (DIRECTOR OF QUALITY MANAGEMENT) |
| Authorized Official Telephone | 4023391436 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | STATE OF ILLINOIS, SUPR | A-2158-0000-A | 01 |
| Street Address |
2605 W 22ND ST STE 29 |
| City | OAK BROOK |
| State | IL |
| Zip Code | 60523-4625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194358630 | Jennifer Renee Earnest | Counselor | 2526 Butterfield Road, Suite 138s, Oakbrook, IL 60523 | 2020-02-12 |
| 1881244614 | Meredith Elise Osborne | Pain Medicine | Joint Relief Institute, 600 22nd Street, Oak Brook, IL 60523 | 2019-09-13 |
| 1811450349 | Jessica A Kras | Physical Therapist | 2011 York Rd., Suite 1500, Oak Brook, IL 60523 | 2019-04-11 |
| 1356804876 | Derek M Jones | Physical Therapist | 2011 N. York Rd., Suite 1500, Oak Brook, IL 60523 | 2019-04-11 |
| 1013439975 | Lydia Schatzel | Counselor | 1520 Kensington Rd Ste 212, Oak Brook, IL 60523 | 2017-07-12 |
| 1821537358 | The Anxiety Treatment Center - Western Suburbs, LLC | Counselor | 1100 Jorie Blvd, 227, Oak Brook, IL 60523 | 2017-02-16 |
| 1265989875 | Advance Inpatient Medicine LLC | Hospitalist | 903 Commerce Drive, Suite 333, Oak Brook, IL 60523 | 2016-09-01 |
| 1154877850 | Sandhya Jayaram Shetty | Specialist/Technologist, Other | 1420 Kensington Rd., 201, Oak Brook, IL 60523 | 2016-09-01 |
| 1801349196 | Delsaz Sultan | Dentist | 1301 W 22nd St Ste 1007, Oak Brook, IL 60523 | 2016-08-03 |
| 1851753636 | Pallan Primary Care Ltd S C | Family Medicine | 2425 W 22nd St Ste 211, Oak Brook, IL 60523 | 2016-03-22 |
| Find all providers in zip 60523 | ||||
| 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 |
|---|---|---|---|---|
| 1861752776 | Breath of Life Professional Services, Nfp, Inc. | Community/Behavioral Health | 2725 35th St, Oak Brook, IL 60523-2612 | 2012-05-24 |
| 1730725110 | Aw Counseling, Pllc | Community/Behavioral Health | 1100 Jorie Blvd, Ste 370, Oak Brook, IL 60523 | 2019-11-20 |
| 1235533431 | Leyden Dupage Counseling Services | Community/Behavioral Health | 1010 Jorie Blvd Ste 12, Oak Brook, IL 60523-4511 | 2014-10-17 |
| 1245642131 | Gruener Consulting, LLC | Community/Behavioral Health | 1010 Jorie Blvd, Suite 112, Oak Brook, IL 60523-2215 | 2014-05-27 |
| 1609295724 | P.s. It's Counseling | Community/Behavioral Health | 1010 Jorie Blvd, Suite 102, Oak Brook, IL 60523-2215 | 2014-04-16 |
| 1427399138 | Tonya Gilkerson | Community/Behavioral Health | 2625 Butterfield Rd Ste 138s, Oak Brook, IL 60523-1244 | 2013-03-05 |
| 1568721447 | Oak Brook Counseling & Wellness Ltd | Community/Behavioral Health | 1010 Jorie Blvd, Oak Brook, IL 60523-2215 | 2012-05-11 |
| 1861750341 | Life To The Fullest LLC | Community/Behavioral Health | 2625 Butterfield Rd, Suite 138s, Oak Brook, IL 60523-1234 | 2012-05-02 |
| 1356532766 | Diana Fox Counseling Services | Community/Behavioral Health | 1550 Spring Rd, The Spectrum Center, Suite 215, Oak Brook, IL 60523-1320 | 2007-08-09 |
| 1275738130 | Shared Vision Psychological Services | Community/Behavioral Health | 1200 Harger Rd, #600, Oak Brook, IL 60523 | 2007-06-19 |
| Find all providers in OAK BROOK | ||||
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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.