Springhealth Behavioral Health and Integrated Care Illinois, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

SPRINGHEALTH BEHAVIORAL HEALTH AND INTEGRATED CARE ILLINOIS, LLC

Practice address

3921 Pintail Dr Ste B
Springfield, IL 62711-6738

Phone

(217) 843-0290

NPI assigned

Feb 18, 2021

Organization subpart

No

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

Authorized official

Name

Angie Mattingly

Title

MGR Provider Enrollment

Phone

(502) 630-7425

Specialties & licenses 1

Addresses

Tax ID family

Springhealth Behavioral Health and Integrated Care Illinois LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Springhealth Behavioral Health and Integrated Care Illinois, LLC

  • Community/Behavioral Health Agency
  • Elmhurst, IL
  • NPI 1053724195
  NPD tax ID

Locations

Practitioners 2

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

• Renee Hamilton

  • Behavior Technician
  • Decatur, IL
  • NPI 1295569580
  NPD
• Kathryn Elizabeth Rahn, RBT

  • Behavior Technician
  • Springfield, IL
  • NPI 1205682408
  NPD

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1063005288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N WHITTINGTON PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402227101",
            "telephone_number": "502-394-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 PINTAIL DR STE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116738",
            "telephone_number": "217-843-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGHEALTH BEHAVIORAL HEALTH AND INTEGRATED CARE ILLINOIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-18",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "MATTINGLY",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "MGR PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "502-630-7425"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Springfield Supportive Living
• Springfield Terrace, LTD
• Springfield Treatment Center, LLC
• Springfield Unit 186
• Springfield Vision Care Associates, LTD
• Christopher A Sprinkel, PA-C
• Sarah Elizabeth Spurling, LCSW
• Cary Squires, MD
• Rajagopal V Sreedhar, MD
• Kimberly Sriner, LCPC

• Behavior Analyst in Springfield, IL
• Providers in Springfield, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.