Diversified Behavioral Services

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

DIVERSIFIED BEHAVIORAL SERVICES

Practice address

11070 S Western Ave
Chicago, IL 60643-3928

Phone

(773) 239-9700

Fax

(773) 239-7506

NPI assigned

Dec 4, 2008

Last updated

Dec 4, 2008By 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. George E. Smith

Title

Ceo/President

Phone

(773) 239-9700

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228348800000",
    "number": "1235374257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11070 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606433928",
            "telephone_number": "773-239-9700",
            "fax_number": "773-239-7506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11070 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606433928",
            "telephone_number": "773-239-9700",
            "fax_number": "773-239-7506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-04",
        "last_updated": "2008-12-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "773-239-9700",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diversified Behavioral Services, Inc.
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• Diversified Urban Consultation Systems Inc
• Srikanth N Divi, M.D.
• Cathy A Divincenzo, MD

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; 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.