Active NPI
The Thresholds
Doing business as Bridge South, Peer Success New Freedom Center South
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Chicago, IL
National Provider Identifier
1174955173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Legal business name
- THE THRESHOLDS
- Practice address
- 718-724 West 47TH St
Chicago, IL 60632 - Phone
- (773) 572-5500
- NPI assigned
- Aug 1, 2013
- Organization subpart
- Yes
- Parent organization
- THE THRESHOLDS
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marcella Klauer
- Title
- Executive Assistant
- Phone
- (773) 572-5480
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Primary |
Addresses
Primary practice location
718-724 West 47TH St
Chicago, IL 60632
Mailing address
4101 N Ravenswood Ave
Chicago, IL 60613-2193
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04133 | Medicaid | IL |
Other names 1
- Bridge South, Peer Success New Freedom Center South
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040517000766 | IL | Part B Supplier - Clinic/Group Practice | 6204826647 |
Receives reassigned benefits from 36 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Part of
- Thresholds West Suburbs
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physician Assistant
- Chicago, IL
- NPI 1447882980
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375315200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1657756800000",
"number": "1174955173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4101 N RAVENSWOOD AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606132193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "718-724 WEST 47TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60632",
"telephone_number": "773-572-5500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE THRESHOLDS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "THE THRESHOLDS",
"enumeration_date": "2013-08-01",
"last_updated": "2022-07-14",
"certification_date": "2022-07-14",
"status": "A",
"authorized_official_last_name": "KLAUER",
"authorized_official_first_name": "MARCELLA",
"authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
"authorized_official_telephone_number": "773-572-5480"
},
"taxonomies": [
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04133",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Bridge South, Peer Success New Freedom Center South",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Bridge South, Peer Success New Freedom Center South",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Chicago, IL
- The Thresholds (Bridge Southwest)
- The Thresholds (West Suburbs)
- The Thresholds (Substance Use Treatment West)
- The Thresholds
- The Thresholds (Southside Housing 2 Rowan Trees)
- The Thresholds (Young Adult Program Hart House)
- The Thresholds
- The Thresholds (West Suburbs Karlov House)
- The Thresholds (Young Adult Program James House)
- The Thresholds (Young Adult Program Houston REACH)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.