Prestige Psychiatry 1 LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

PRESTIGE PSYCHIATRY 1 LLC

Doing business as

Prestige Psychiatry1 LLC

Practice address

1413 S Addison Ave
Lombard, IL 60148-4118

Phone

(630) 520-4657

NPI assigned

May 13, 2022

Last updated

Jul 10, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shuja Uddin, MDNPI 1871832790

Title

President

Phone

(630) 520-4657

Specialties & licenses 1

Addresses

Other names 1

• Prestige Psychiatry1 LLC Doing business as

Practitioners 1

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.

• Shuja Uddin, M.D.

  • Psychiatry Physician
  • Syracuse, NY
  • NPI 1871832790

  Multi-Specialty

  NPD Authorized official

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1225775018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 S ADDISON AVE",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484118",
            "telephone_number": "630-520-4657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 S ADDISON AVE",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484118",
            "telephone_number": "630-520-4657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE PSYCHIATRY 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-13",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "UDDIN",
        "authorized_official_first_name": "SHUJA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-520-4657",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Psychiatry1 LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexandria Powell
• Shantel Powell, BA
• PPG Labs LLC
• Susan M Prado, IBCLC
• Premier Family Health and Wellness Center Inc (Premier MedSpa)
• Wayne F Price, MSW
• Primary Care Services
• Primebox LLC
• Professional Clinical Counseling
• Progressive Physical Medicine S.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.