NPIMap

Organization Active NPI

Preventative Mental Healthcare Services

  • Clinical Psychologist
  • Downers Grove, IL
National Provider Identifier
1407984131
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
PREVENTATIVE MENTAL HEALTHCARE SERVICES
Practice address
1001 Ogden Ave
LL5
Downers Grove, IL 60515-2865
Phone
(630) 968-1181
Fax
(630) 322-9977
NPI assigned
Mar 2, 2007
Last updated
Dec 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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

Authorized official

Name
Mr. Joseph S Angelillo
Title
Director
Phone
(630) 968-1181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

1001 Ogden Ave
LL5
Downers Grove, IL 60515-2865

Mailing address

1001 Ogden Ave
LL5
Downers Grove, IL 60515-2865
Phone (630) 968-1181

National Provider Directory

National Provider Directory

Locations

1001 Ogden Ave
Ste LL5
Downers Grove, IL 60515
Phone (312) 782-8247

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417478400000",
    "number": "1407984131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 OGDEN AVE",
            "address_2": "LL5",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152865",
            "telephone_number": "630-968-1181",
            "fax_number": "630-322-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 OGDEN AVE",
            "address_2": "LL5",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152865",
            "telephone_number": "630-968-1181",
            "fax_number": "630-322-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTATIVE MENTAL HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2014-12-02",
        "status": "A",
        "authorized_official_last_name": "ANGELILLO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "630-968-1181",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.