Advanced Psychiatry Clinics, S.C.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

ADVANCED PSYCHIATRY CLINICS, S.C.

Practice address

5519 N Cumberland Ave Ste 1016
Chicago, IL 60656-1480

Phone

(708) 224-8840

Fax

(773) 594-7721

NPI assigned

Jun 9, 2020

Organization subpart

No

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

Authorized official

Name

Marek Walczyk, MDNPI 1447243373

Title

President

Phone

(708) 224-8840

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marek Walczyk, M.D.

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1447243373
  NPD Authorized official

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591660800000",
    "number": "1164047833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5519 N CUMBERLAND AVE STE 1016",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606561480",
            "telephone_number": "708-224-8840",
            "fax_number": "773-594-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5519 N CUMBERLAND AVE STE 1016",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606561480",
            "telephone_number": "708-224-8840",
            "fax_number": "773-594-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PSYCHIATRY CLINICS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A",
        "authorized_official_last_name": "WALCZYK",
        "authorized_official_first_name": "MAREK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-224-8840",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "36107779",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Internet",
            "affiliation": "N",
            "address_1": "5519 N Cumberland Ave Ste 1016",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606561480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychiatry Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; 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.