NPIMap

Organization Active NPI

Institute of Neurobehavior Services SC

  • Psychiatry Physician
  • Orland Park, IL
National Provider Identifier
1346661139
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036126035 Issued in IL
Legal business name
INSTITUTE OF NEUROBEHAVIOR SERVICES SC
Practice address
14315 108TH Ave
Suite 215
Orland Park, IL 60467-5700
Phone
(708) 586-9751
NPI assigned
Dec 20, 2013
Last updated
Dec 20, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Authorized official

Name
Dr. Evaldas Radzevicius, MDNPI 1750376869
Title
Director of Operations
Phone
(312) 860-7017

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X NU
Professional Counselor 101YP2500X NU
Psychiatry Physician 2084P0800X 036126035 IL Primary

Addresses

Primary practice location

14315 108TH Ave
Suite 215
Orland Park, IL 60467-5700

Mailing address

14315 108TH Ave
Suite 215
Orland Park, IL 60467-5700
Phone (708) 586-9751

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140313002020 IL Part B Supplier - Clinic/Group Practice 7618107608 Receives reassigned benefits from 10 practitioners
Practice locations: Harvey, IL; Tinley Park, IL; Romeoville, IL; Palos Park, IL; Orland Park, IL; Orland Lawn, IL; Oak Lawn, IL; Hazel Crest, IL…

National Provider Directory

National Provider Directory

Locations

14315 108th Ave
Ste 215
Orland Park, IL 60467
Phone (708) 586-9751

Practitioners & affiliated clinicians

Practitioners 10

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": "1387497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387497600000",
    "number": "1346661139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14315 108TH AVE",
            "address_2": "SUITE 215",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675700",
            "telephone_number": "708-586-9751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14315 108TH AVE",
            "address_2": "SUITE 215",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675700",
            "telephone_number": "708-586-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE OF NEUROBEHAVIOR SERVICES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-20",
        "last_updated": "2013-12-20",
        "status": "A",
        "authorized_official_last_name": "RADZEVICIUS",
        "authorized_official_first_name": "EVALDAS",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "312-860-7017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036126035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.