NPIMap

Organization Active NPI

Proactive Behavioral Services, Inc.

  • Clinical Psychologist
  • Inverness, IL
National Provider Identifier
1043437049
Registry record updated May 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071--007171 Issued in IL
Legal business name
PROACTIVE BEHAVIORAL SERVICES, INC.
Practice address
1644 W. Colonial Pkwy.
Inverness, IL 60067-1207
Phone
(847) 776-4500
Fax
(847) 776-4724
NPI assigned
Apr 19, 2007
Last updated
May 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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

Authorized official

Name
Dr. Todd R. Lendvay, PSYDNPI 1417010687
Title
President/Owner
Phone
(847) 778-4500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 071--007171 IL Primary

Addresses

Primary practice location

1644 W. Colonial Pkwy.
Inverness, IL 60067-1207

Mailing address

1644 W. Colonial Pkwy.
Inverness, IL 60067-1207
Phone (847) 776-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080614000036 IL Part B Supplier - Clinic/Group Practice 7618048950 Receives reassigned benefits from 10 practitioners
Practice locations: Algonquin, IL

National Provider Directory

National Provider Directory
Tax ID family
Proactive Behavioral Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9113 Trinity Dr
Lake in the Hills, IL 60156
Phone (847) 462-6099

Practitioners & affiliated clinicians

Practitioners 12

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": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1043437049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1644 W. COLONIAL PKWY.",
            "city": "INVERNESS",
            "state": "IL",
            "postal_code": "600671207",
            "telephone_number": "847-776-4500",
            "fax_number": "847-776-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1644 W. COLONIAL PKWY.",
            "city": "INVERNESS",
            "state": "IL",
            "postal_code": "600671207",
            "telephone_number": "847-776-4500",
            "fax_number": "847-776-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE BEHAVIORAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "LENDVAY",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "847-778-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071--007171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inverness, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.