Organization Active NPI

Paula P. Merucci, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Evanston, IL
National Provider Identifier
1114434404
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
149017859 Issued in IL
Legal business name
PAULA P. MERUCCI, LLC
Practice address
2530 Crawford Ave Ste 201
Evanston, IL 60201-4959
Phone
(847) 859-6033
Fax
(847) 241-0305
NPI assigned
Jan 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Authorized official

Name
Paula P MerucciNPI 1932542131
Title
Owner
Phone
(847) 859-6033

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 149017859 IL Primary

Addresses

Primary practice location

2530 Crawford Ave Ste 201
Evanston, IL 60201-4959

Mailing address

2550 Wellington CT
Evanston, IL 60201-4975
Phone (847) 962-2639

Other practice location 1

2550 Wellington Ct
Evanston, IL 60201-4975
Phone (847) 962-2639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180315001250 IL Part B Supplier - Clinic/Group Practice 7012279870 Receives reassigned benefits from 1 practitioner
Practice locations: Evanston, IL

National Provider Directory

National Provider Directory

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": "1515369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753056000000",
    "number": "1114434404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 WELLINGTON CT",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014975",
            "telephone_number": "847-962-2639",
            "fax_number": "847-241-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CRAWFORD AVE STE 201",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014959",
            "telephone_number": "847-859-6033",
            "fax_number": "847-241-0305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 Wellington Ct",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602014975",
            "country_code": "US",
            "telephone_number": "847-962-2639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAULA P. MERUCCI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-08",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A",
        "authorized_official_last_name": "MERUCCI",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-859-6033"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "IL",
            "license": "149017859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.