NPIMap

Organization Active NPI

Envision Unlimited

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
National Provider Identifier
1346732989
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
18004 Issued in IL
Legal business name
ENVISION UNLIMITED
Practice address
4828 W Cornelia Ave
Chicago, IL 60641
Phone
(773) 676-2123
NPI assigned
May 30, 2018
Last updated
Aug 16, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
ENVISION UNLIMITEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Authorized official

Name
Linda A Bruggemann, LPCNPI 1740499938
Title
Billing Coordinator
Phone
(773) 506-3201

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 18004 IL Primary
Mental Illness Community Based Residential Treatment Facility 320800000X

Addresses

Primary practice location

4828 W Cornelia Ave
Chicago, IL 60641

Mailing address

5080 N Elston Ave
Chicago, IL 60630-2459
Phone (773) 506-3201

Other names 1

  • Cornelia Other name

National Provider Directory

National Provider Directory
Tax ID family
Envision Unlimited Foster Care Program25 organizations share this tax ID, including this one
Part of
Envision Unlimited Foster Care Program

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1346732989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302459",
            "telephone_number": "773-506-3201",
            "fax_number": "773-769-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4828 W CORNELIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60641",
            "telephone_number": "773-676-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION UNLIMITED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ENVISION UNLIMITED",
        "enumeration_date": "2018-05-30",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "BRUGGEMANN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "773-506-3201",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "18004",
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornelia",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 16, 2018; 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.