Individual provider Active NPI

Angela H Mahome, MD

  • Psychiatry Physician
  • Palos Park, IL
National Provider Identifier
1265576011
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Practice address
13011 S 104TH Ave
Suite 200
Palos Park, IL 60464-1500
Phone
(708) 448-3300
Fax
(708) 448-6972
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X IL Primary

Addresses

Primary practice location

13011 S 104TH Ave
Suite 200
Palos Park, IL 60464-1500

Mailing address

13011 S 104TH Ave
Suite 200
Palos Park, IL 60464-1500
Phone (708) 448-3300

Other identifiers 1

IdentifierTypeStateIssuer
01623882OtherILBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041130000527 IL Practitioner - Psychiatry 3072578277 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clarity Clinic LLCGroup PAC ID 7517284755, 110 clinicians

Practice addresses (Care Compare)

1 E Superior St
Suite 306
Chicago, IL 60611-2595
Phone (312) 754-9404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago BH Hospital, LLC Psychiatry CurrentSince Feb 15, 2024 Accepting new patients
Clarity Clinic PLLC CurrentSince Oct 1, 2025 Accepting new patients
Chicago BH Hospital, LLC CurrentSince Feb 15, 2024 Accepting new patients
Chicago BH Hospital, LLC Current Accepting new patients
Healing Center for Behavioral Health Past Accepting new patients
Miracare Neuro Behavioral Health, PC Psychiatry Past Accepting new patients

Locations

4720 N Clarendon Ave
Chicago, IL 60640
Phone (773) 313-4401

4840 N Marine Dr
Chicago, IL 60640
Phone (773) 878-9700

850 W Lawrence Ave
Chicago, IL 60640
Phone (773) 357-6772

1 E Superior St
Ste 306
Chicago, IL 60611
Phone (312) 754-9404

6100 Tower Cir
Ste 1000
Franklin, TN 37067
Phone (615) 454-7459

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265576011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13011 S 104TH AVE",
            "address_2": "SUITE 200",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641500",
            "telephone_number": "708-448-3300",
            "fax_number": "708-448-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13011 S 104TH AVE",
            "address_2": "SUITE 200",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641500",
            "telephone_number": "708-448-3300",
            "fax_number": "708-448-6972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHOME",
        "first_name": "ANGELA",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01623882",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Park, IL

Sources for this page

Verify at the official NPI Registry.