NPIMap

Organization Active NPI

Pilsen-Little Village Community Mental Health Center, Inc.

Doing business as Pilsen Wellness Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Berwyn, IL
National Provider Identifier
1225418577
Registry record updated Apr 9, 2021
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
PILSEN-LITTLE VILLAGE COMMUNITY MENTAL HEALTH CENTER, INC.
Doing business as
Pilsen Wellness Center, Inc
Practice address
2600 Ridgeland Ave
Berwyn, IL 60402-2725
Phone
(708) 317-5926
NPI assigned
Jun 2, 2015
Last updated
Apr 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Authorized official

Name
Dr. Francisco Cisneros
Title
Presicent/Ceo
Phone
(773) 579-0832

Specialties & licenses 1

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

Addresses

Primary practice location

2600 Ridgeland Ave
Berwyn, IL 60402-2725

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

2600 Ridgeland Ave
Berwyn, IL 60402
Phone (708) 317-5926

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1225418577",
    "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": "2600 RIDGELAND AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022725",
            "telephone_number": "708-317-5926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PILSEN-LITTLE VILLAGE COMMUNITY MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "CISNEROS",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_title_or_position": "PRESICENT/CEO",
        "authorized_official_telephone_number": "773-579-0832",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pilsen Wellness Center, Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pilsen Wellness Center, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.