NPIMap

Organization Active NPI

Palos Psychiatric & Recovery Inst LTD

  • Clinical Psychologist
  • Palos Heights, IL
National Provider Identifier
1063497345
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
PALOS PSYCHIATRIC & RECOVERY INST LTD
Practice address
7300 W College Dr
101
Palos Heights, IL 60463-1152
Phone
(708) 448-8470
Fax
(708) 448-9651
NPI assigned
Dec 9, 2005
Last updated
Dec 11, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Authorized official

Name
Mrs. Dalia Collazo
Title
Ins Coordinator
Phone
(708) 448-8470

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X IL
Mental Health Counselor 101YM0800X 18000637 IL
Clinical Psychologist 103TC0700X IL Primary
Clinical Psychologist 103TC0700X IL
Social Worker 104100000X IL

Addresses

Primary practice location

7300 W College Dr
101
Palos Heights, IL 60463-1152

Mailing address

7300 W College Dr
Suite 101
Palos Heights, IL 60463-1152
Phone (708) 448-8470

National Provider Directory

National Provider Directory

Locations

7300 W College Dr
Palos Heights, IL 60463
Phone (708) 448-7848

Practitioners & affiliated clinicians

Practitioners 5

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": "1134086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1063497345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 W COLLEGE DR",
            "address_2": "SUITE 101",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631152",
            "telephone_number": "708-448-8470",
            "fax_number": "708-448-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 W COLLEGE DR",
            "address_2": "101",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631152",
            "telephone_number": "708-448-8470",
            "fax_number": "708-448-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALOS PSYCHIATRIC & RECOVERY INST LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-09",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "COLLAZO",
        "authorized_official_first_name": "DALIA",
        "authorized_official_title_or_position": "INS COORDINATOR",
        "authorized_official_telephone_number": "708-448-8470",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "18000637",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.