NPIMap

Organization Active NPI

Pilsen-Little Village Community Mental Health Center, Inc.

  • Community/Behavioral Health Agency
  • Chicago, IL
National Provider Identifier
1154744480
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
04113 Issued in IL
Legal business name
PILSEN-LITTLE VILLAGE COMMUNITY MENTAL HEALTH CENTER, INC.
Practice address
1518 E 63Rd St
Chicago, IL 60637-2921
Phone
(773) 579-0832
Fax
(773) 579-0762
NPI assigned
Jan 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Authorized official

Name
Dr. Francisco Cisneros, PH.D.
Title
President/Ceo
Phone
(773) 579-0982

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 04113 IL Primary

Addresses

Primary practice location

1518 E 63Rd St
Chicago, IL 60637-2921

Mailing address

2319 S Damen Ave
Chicago, IL 60608-4209
Phone (773) 579-0832

Other names 1

  • Pilsen Wellness Center, Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pilsen Wellness Center Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations

1518 E 63rd St
Chicago, IL 60637
Phone (312) 225-1100

NPI Registry JSON

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390348800000",
    "number": "1154744480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2319 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084209",
            "telephone_number": "773-579-0832",
            "fax_number": "773-579-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 E 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606372921",
            "telephone_number": "773-579-0832",
            "fax_number": "773-579-0762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PILSEN-LITTLE VILLAGE COMMUNITY MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-22",
        "last_updated": "2014-01-22",
        "status": "A",
        "authorized_official_last_name": "CISNEROS",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "773-579-0982",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "04113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pilsen Wellness Center, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 22, 2014; 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.