Organization Active NPI

Bridging the Tys to Jordan Inc

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Chicago, IL
National Provider Identifier
1083884019
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
Legal business name
BRIDGING THE TYS TO JORDAN INC
Practice address
5500 S Indiana Ave BSMT
Chicago, IL 60637-1011
Phone
(773) 425-8159
Fax
(773) 488-9462
NPI assigned
Mar 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Authorized official

Name
Tyson EverettNPI 1255717385
Title
Executive Director
Phone
(773) 425-8159

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X A-3249-0001 IL
Community/Behavioral Health Agency 251S00000X
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Substance Use Disorder Rehabilitation Hospital Unit 276400000X
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

5500 S Indiana Ave BSMT
Chicago, IL 60637-1011

Mailing address

5500 S Indiana Ave BSMT
Chicago, IL 60637-1011
Phone (773) 425-8159

National Provider Directory

National Provider Directory

Locations

5500 S Indiana Ave
Bsmt
Chicago, IL 60637
Phone (773) 425-8159

7122 S Vincennes Ave
Ste B
Chicago, IL 60621

Practitioners & affiliated clinicians

Practitioners 1

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": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1083884019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 S INDIANA AVE BSMT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371011",
            "telephone_number": "773-425-8159",
            "fax_number": "773-488-9462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 S INDIANA AVE BSMT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371011",
            "telephone_number": "773-425-8159",
            "fax_number": "773-488-9462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGING THE TYS TO JORDAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "TYSON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "773-425-8159"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "IL",
            "license": "A-3249-0001",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Oct 22, 2025; 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.