NPIMap

Organization Active NPI

Maryville Academy

Doing business as Family Behavioral Health Clinic

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Chicago, IL
National Provider Identifier
1366957292
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
MARYVILLE ACADEMY
Doing business as
Family Behavioral Health Clinic
Practice address
1510 N Claremont Ave
Chicago, IL 60622-1710
Phone
(312) 491-3509
Fax
(312) 391-3531
NPI assigned
Dec 14, 2017
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Nancy Z Woulfe
Title
Director of Business Development
Phone
(847) 294-1910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

1510 N Claremont Ave
Chicago, IL 60622-1710

Mailing address

1455 E Golf Rd Ste 210
Des Plaines, IL 60016-1254
Phone (847) 390-3004

Other names 1

  • Family Behavioral Health Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Maryville Academy28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1366957292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 E GOLF RD STE 210",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161254",
            "telephone_number": "847-390-3004",
            "fax_number": "847-390-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 N CLAREMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221710",
            "telephone_number": "312-491-3509",
            "fax_number": "312-391-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYVILLE ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-14",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "WOULFE",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "847-294-1910"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Behavioral Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 11, 2025; 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.