Active NPI
Seryne Collective LLC
- Developmentally Disabled Services Day Training Agency
- Chicago, IL
National Provider Identifier
1396637666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmentally Disabled Services Day Training Agency
- Legal business name
- SERYNE COLLECTIVE LLC
- Practice address
- 5007 W Augusta Blvd
Chicago, IL 60651-4471 - Phone
- (312) 998-5527
- NPI assigned
- Jul 19, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shikota Bridgemon
- Title
- Executive Director
- Phone
- (312) 998-5527
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 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | Primary | ||
| Home Health Agency | 251E00000X | |||
| Nursing Care Agency | 251J00000X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Non-emergency Medical Transport (VAN) | 343900000X | |||
| Respite Care | 385H00000X |
Addresses
Primary practice location
5007 W Augusta Blvd
Chicago, IL 60651-4471
Mailing address
10720 5TH Ave NE
Seattle, WA 98125-7260
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Registered Nurse
- Chicago, IL
- NPI 1023900396
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752883200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1752883200000",
"number": "1396637666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10720 5TH AVE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981257260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5007 W AUGUSTA BLVD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606514471",
"telephone_number": "312-998-5527"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SERYNE COLLECTIVE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-07-19",
"last_updated": "2025-07-19",
"certification_date": "2025-07-19",
"status": "A",
"authorized_official_last_name": "BRIDGEMON",
"authorized_official_first_name": "SHIKOTA",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "312-998-5527"
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": true
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": null,
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Jul 19, 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.