Organization Active NPI

New Birth Christian Center

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1033423835
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
NEW BIRTH CHRISTIAN CENTER
Practice address
5335 Lemoyne St
Chicago, IL 60651-1326
Phone
(773) 261-7404
Fax
(773) 751-2250
NPI assigned
Aug 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2010

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

Authorized official

Name
Mr. Robbie Wilkerson, PASTOR
Title
Pres
Phone
(773) 261-7404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

5335 Lemoyne St
Chicago, IL 60651-1326

Mailing address

5335 W Lemoyne
Chicago, IL 60651-1326
Phone (773) 261-7404

National Provider Directory

National Provider Directory

Locations

4255 W Division St
Chicago, IL 60651
Phone (773) 261-7404

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280880000000",
    "number": "1033423835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5335 W LEMOYNE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606511326",
            "telephone_number": "773-261-7404",
            "fax_number": "773-751-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5335 LEMOYNE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606511326",
            "telephone_number": "773-261-7404",
            "fax_number": "773-751-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BIRTH CHRISTIAN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-04",
        "last_updated": "2010-08-04",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "ROBBIE",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "773-261-7404",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PASTOR"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 4, 2010; 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.