Individual provider Active NPI

Michelle Mannino-Purkey, MFT

  • Marriage & Family Therapist
  • Chicago, IL
National Provider Identifier
1114298148
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166.000851 Issued in IL
Practice address
30 N Michigan Ave Ste 1217
Chicago, IL 60602-3732
Phone
(312) 725-3093
NPI assigned
Jan 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166.000851 IL Primary

Addresses

Primary practice location

30 N Michigan Ave Ste 1217
Chicago, IL 60602-3732

Mailing address

6232 N Pulaski Rd Ste 400
Chicago, IL 60646-5133
Phone (312) 725-3093

Other practice location 1

6232 N Pulaski Rd Ste 400
Chicago, IL 60646-5133
Phone (312) 725-3093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
166.000851ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Psychiatric Services LTD CurrentSince Jan 1, 2024 Accepting new patients

Locations

11231 Distinctive Dr
Orland Park, IL 60467
Phone (800) 461-9433

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1114298148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6232 N PULASKI RD STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465133",
            "telephone_number": "312-725-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE STE 1217",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023732",
            "telephone_number": "312-725-3093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6232 N Pulaski Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606465133",
            "country_code": "US",
            "telephone_number": "312-725-3093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANNINO-PURKEY",
        "first_name": "MICHELLE",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-23",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.000851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.