NPIMap

Organization Active NPI

Maryville Academy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
National Provider Identifier
1144957010
Registry record updated May 8, 2023
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
MARYVILLE ACADEMY
Practice address
6650 W Irving Park Rd
Chicago, IL 60634-2435
Phone
(773) 205-3605
Fax
(773) 205-3639
NPI assigned
Aug 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Authorized official

Name
Nancy Z Woulfe
Title
Director of Business Development
Phone
(847) 294-1910

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

6650 W Irving Park Rd
Chicago, IL 60634-2435

Mailing address

6650 W Irving Park Rd
Chicago, IL 60634-2435

Other names 1

  • Maryville Crisis Nursery Other name

National Provider Directory

National Provider Directory
Tax ID family
Maryville Academy28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1144957010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6650 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342435",
            "telephone_number": "773-205-3605",
            "fax_number": "773-205-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYVILLE ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-02",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "WOULFE",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "847-294-1910"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maryville Crisis Nursery",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Maryville Crisis Nursery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 May 8, 2023; 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.