Endeavor Mental Healthcare and Medical Services LTD

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ENDEAVOR MENTAL HEALTHCARE AND MEDICAL SERVICES LTD

Practice address

10336 S Western Ave
Chicago, IL 60643-2407

Phone

(773) 405-8076

Fax

(605) 309-7783

NPI assigned

May 6, 2024

Last updated

Aug 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patricia VowalNPI 1063832541

Title

Nurse Practitioner

Phone

(773) 405-8076

Specialties & licenses 3

Addresses

Other names 1

• Endeavor Clinical Healthcare services Former legal business name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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.

• Patricia Ann Vowal

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
  • NPI 1063832541

  Family

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1114774296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10611 SOUTH LOWE",
            "address_2": "HOUSE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60628",
            "telephone_number": "773-405-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10336 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432407",
            "telephone_number": "773-405-8076",
            "fax_number": "605-309-7783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Advocate Trinity Hospital",
            "address_2": "2320 East 93rd St. Chicago",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60617",
            "country_code": "US",
            "telephone_number": "773-405-8076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8012 South Crandon",
            "address_2": "house",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60617",
            "country_code": "US",
            "telephone_number": "773-365-5303",
            "fax_number": "773-356-5178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ENDEAVOR MENTAL HEALTHCARE AND MEDICAL SERVICES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "VOWAL",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "773-405-8076"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endeavor Clinical Healthcare services",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Endeavor Clinical Healthcare services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.