NPIMap

Organization Active NPI

Midwest Neuropsychiatric Assoc LTD

  • Specialist
  • Chicago, IL
National Provider Identifier
1003949793
Registry record updated Dec 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
042002366 Issued in IL
Legal business name
MIDWEST NEUROPSYCHIATRIC ASSOC LTD
Practice address
1725 W Harrison St
Suite 744
Chicago, IL 60612-3841
Phone
(312) 942-0118
Fax
(312) 942-1331
NPI assigned
Mar 13, 2007
Last updated
Dec 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Jane Carley, B.A.
Title
Office Manager
Phone
(312) 942-9319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 042002366 IL Primary

Addresses

Primary practice location

1725 W Harrison St
Suite 744
Chicago, IL 60612-3841

Mailing address

1725 W Harrison St
Suite 744
Chicago, IL 60612-3841
Phone (312) 942-0118

Other identifiers 1

IdentifierTypeStateIssuer
1615745OtherILBLUE CROSS-BLUE SHIELD #

National Provider Directory

National Provider Directory

Locations

1725 W Harrison St
Ste 744
Chicago, IL 60612
Phone (312) 942-0118

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324944000000",
    "number": "1003949793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST",
            "address_2": "SUITE 744",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-942-0118",
            "fax_number": "312-942-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST",
            "address_2": "SUITE 744",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-942-0118",
            "fax_number": "312-942-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST NEUROPSYCHIATRIC ASSOC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2011-12-27",
        "status": "A",
        "authorized_official_last_name": "CARLEY",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "312-942-9319",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "B.A."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "042002366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE SHIELD #",
            "identifier": "1615745",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.