NPIMap

Organization Active NPI

Stickney Public Health District, Behavioral Health Division

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Burbank, IL
National Provider Identifier
1154868206
Registry record updated Jan 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
04131 Issued in IL
Legal business name
STICKNEY PUBLIC HEALTH DISTRICT, BEHAVIORAL HEALTH DIVISION
Practice address
5635 State Rd
Burbank, IL 60459-2051
Phone
(708) 424-9200
Fax
(708) 424-9267
NPI assigned
Jan 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2017

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

Authorized official

Name
Dr. Christopher Leon Grunow, PSY.D.
Title
Health Director
Phone
(708) 424-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 04131 IL Primary

Addresses

Primary practice location

5635 State Rd
Burbank, IL 60459-2051

Mailing address

5635 State Rd
Burbank, IL 60459-2051
Phone (708) 424-9200

National Provider Directory

National Provider Directory
Tax ID family
Behavioral Health Clinic5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1485475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485475200000",
    "number": "1154868206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5635 STATE RD",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604592051",
            "telephone_number": "708-424-9200",
            "fax_number": "708-424-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5635 STATE RD",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604592051",
            "telephone_number": "708-424-9200",
            "fax_number": "708-424-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STICKNEY PUBLIC HEALTH DISTRICT, BEHAVIORAL HEALTH DIVISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-27",
        "last_updated": "2017-01-27",
        "status": "A",
        "authorized_official_last_name": "GRUNOW",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "708-424-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "04131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; 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.