Immakulate Psychiatry LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

IMMAKULATE PSYCHIATRY LLC

Practice address

5730 W Roosevelt Rd
Chicago, IL 60644-1580

Phone

(773) 413-1700

NPI assigned

Aug 23, 2022

Last updated

Aug 23, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ahmed Maki, DONPI 1215466164

Title

Provider

Phone

(847) 280-1505

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Ahmed Maki, DO

  • Psychiatry Physician
  • North Chicago, IL
  • NPI 1215466164
  Authorized official Same address or phone

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1033838081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1373 DIVISION ST",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353059",
            "telephone_number": "847-280-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 W ROOSEVELT RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606441580",
            "telephone_number": "773-413-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMAKULATE PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "MAKI",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "847-280-1505",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sonja Imhoof, LSW
• Acacia Imler, RN
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• Immediate Pain Care of Evanston, LLC
• David Mayo Immen, MD

• Psychiatry Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.