Organization Active NPI

Core Behavioral Health, Inc.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1316249576
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071007541 Issued in IL
Legal business name
CORE BEHAVIORAL HEALTH, INC.
Practice address
1300 W Belmont Ave
Suite # 504
Chicago, IL 60657-3200
Phone
(800) 994-6602
Fax
(800) 994-6602
NPI assigned
Nov 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Authorized official

Name
Dr. Rashid A. Raja, PSY.D.NPI 1386705572
Title
Clinical Psychologist
Phone
(800) 994-6602

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 071007541 IL Primary

Addresses

Primary practice location

1300 W Belmont Ave
Suite # 504
Chicago, IL 60657-3200

Mailing address

9217 Montgomery Dr
Orland Park, IL 60462-6506
Phone (800) 994-6602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201006001665 IL Part B Supplier - Clinic/Group Practice 5193144459 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

1300 W Belmont Ave
Ste 504
Chicago, IL 60657
Phone (800) 994-6602

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1290297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604016000000",
    "number": "1316249576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9217 MONTGOMERY DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604626506",
            "telephone_number": "800-994-6602",
            "fax_number": "800-994-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W BELMONT AVE",
            "address_2": "SUITE # 504",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573200",
            "telephone_number": "800-994-6602",
            "fax_number": "800-994-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-21",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A",
        "authorized_official_last_name": "RAJA",
        "authorized_official_first_name": "RASHID",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "800-994-6602",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; 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.

Verify at the official NPI Registry.