Child Psychiatric Services, LTD.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

036-108993 Issued in IL

Legal business name

CHILD PSYCHIATRIC SERVICES, LTD.

Practice address

495 Central Ave
Suite 203
Northfield, IL 60093-3044

Phone

(847) 251-1046

Fax

(847) 789-7172

NPI assigned

Apr 14, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Alexander Kek

Title

Administrator

Phone

(847) 251-1046

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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

• Anna Ivanenko, MD PHD

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Elk Grove Village, IL
  • NPI 1255308334
  Medicare reassignment
• Ellen Sotoloff, LCPC

  • Mental Health Counselor
  • Northfield, IL
  • NPI 1558754226
  NPD (past)

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1386818011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82",
            "city": "KENILWORTH",
            "state": "IL",
            "postal_code": "600430082",
            "telephone_number": "847-251-1046",
            "fax_number": "847-789-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 CENTRAL AVE",
            "address_2": "SUITE 203",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933044",
            "telephone_number": "847-251-1046",
            "fax_number": "847-789-7172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD PSYCHIATRIC SERVICES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2014-12-30",
        "status": "A",
        "authorized_official_last_name": "KEK",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-251-1046",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "036-108993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron Chang
• Charles Galanis MDSC
• Ali Charnov, LPC
• Lillian T. Chen-Byerley, MS, OTR/L, RCTC
• Chicago Chiropractic & Sports Medicine LLC
• Children's Clinic, LLC (Chicago Children's Clinic)
• Kendra Rand Chilewich, PT, MPT, DPT
• Gloria Lee Christiansen, R.PH
• Georgia Christopoulos, PHARMACIST
• Sabrina Cinqui, DDS

• Clinical Neuropsychologist in Northfield, IL
• Providers in Northfield, IL by specialty
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.