Individual provider Active NPI

Caleb Manuel Reyes, PSYCHIATRIST

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1356872949
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036.155274 Issued in IL
Practice address
6500 N Clark St
Chicago, IL 60626-4097
Phone
(773) 388-1600
Fax
(773) 388-8664
NPI assigned
Mar 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 036.155274 IL Primary

Addresses

Primary practice location

6500 N Clark St
Chicago, IL 60626-4097

Mailing address

4025 N Sheridan Rd
Chicago, IL 60613-2010
Phone (210) 835-5091

Other practice location 1

1740 W Taylor St
Chicago, IL 60612-7232
Phone (866) 600-2273

Other identifiers 1

IdentifierTypeStateIssuer
036.155274MedicaidIL

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
I20210623003709 IL Practitioner - Psychiatry 8325370851 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.155274ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Brown Health Center CurrentSince Jun 14, 2021 Accepting new patients
Howard Brown Health Center Current Accepting new patients
Howard Brown Health Center CurrentSince Jun 14, 2021 Accepting new patients
Howard Brown Health Center Past Accepting new patients

Locations

6500 N Clark St
Chicago, IL 60626
Phone (773) 681-5033

4025 N Sheridan Rd
Chicago, IL 60613
Phone (773) 388-1800

Interoperability endpoints

  • Direct secure messaging: creyes581366@direct.ochin.org

Organizations & group practices 4

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": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1356872949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132010",
            "telephone_number": "210-835-5091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606264097",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-8664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127232",
            "country_code": "US",
            "telephone_number": "866-600-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYES",
        "first_name": "CALEB",
        "middle_name": "MANUEL",
        "credential": "PSYCHIATRIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.155274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036.155274",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.