NPIMap

Organization Active NPI

Caritas

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
National Provider Identifier
1104059864
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CARITAS
Practice address
140 N Ashland Ave
Chicago, IL 60607-1802
Phone
(312) 850-0050
Fax
(312) 850-9095
NPI assigned
Aug 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Authorized official

Name
Jesseca Watson
Title
Credentialing Manager
Phone
(630) 572-8228

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Psychiatric Residential Treatment Facility 323P00000X 07008 IL

Addresses

Primary practice location

140 N Ashland Ave
Chicago, IL 60607-1802

Mailing address

1301 W 22ND St
Suite 800
Oak Brook, IL 60523-2006
Phone (630) 572-8228

Other identifiers 2

IdentifierTypeStateIssuer
07008MedicaidIL
006MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Caritas12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

1301 W 22nd St
Ste 800
Oak Brook, IL 60523

NPI Registry JSON

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

{
    "created_epoch": "1251417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1104059864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 W 22ND ST",
            "address_2": "SUITE 800",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232006",
            "telephone_number": "630-572-8228",
            "fax_number": "630-572-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071802",
            "telephone_number": "312-850-0050",
            "fax_number": "312-850-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARITAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-28",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "JESSECA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "630-572-8228"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "IL",
            "license": "07008",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07008",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006",
            "state": "IL"
        }
    ],
    "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, 2020; 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.