NPIMap

Organization Active NPI

Maryville Academy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Berwyn, IL
National Provider Identifier
1427710722
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MARYVILLE ACADEMY
Practice address
St. Mary of Celle
1431 Euclid Avenue
Berwyn, IL 60402
Phone
(630) 736-7480
NPI assigned
Oct 13, 2021
Last updated
Jul 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Mental Illness Community Based Residential Treatment Facility 320800000X

Addresses

Primary practice location

St. Mary of Celle
1431 Euclid Avenue
Berwyn, IL 60402

Mailing address

1150 N River Rd
Des Plaines, IL 60016-1214
Phone (847) 294-1910

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

Locations

1431 Euclid Ave
Berwyn, IL 60402
Phone (630) 736-7480

1150 N River Rd
Des Plaines, IL 60016
Phone (847) 294-1999

NPI Registry JSON

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658188800000",
    "number": "1427710722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N RIVER RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161214",
            "telephone_number": "847-294-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST. MARY OF CELLE",
            "address_2": "1431 EUCLID AVENUE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "60402",
            "telephone_number": "630-736-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYVILLE ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-13",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-08",
        "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": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.