NPIMap

Organization Active NPI

Stickney Public Health District

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stickney, IL
National Provider Identifier
1457649246
Registry record updated Jul 14, 2011
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
STICKNEY PUBLIC HEALTH DISTRICT
Practice address
6721 40TH St
Stickney, IL 60402-4174
Phone
(708) 788-9100
Fax
(708) 788-4856
NPI assigned
Jul 14, 2011
Last updated
Jul 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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

Authorized official

Name
Dr. Chistopher Grunow, PSY.D.
Title
Health Director
Phone
(708) 424-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

6721 40TH St
Stickney, IL 60402-4174

Mailing address

6721 40TH St
Stickney, IL 60402-4174
Phone (708) 788-9100

National Provider Directory

National Provider Directory
Tax ID family
Behavioral Health Clinic5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310601600000",
    "number": "1457649246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6721 40TH ST",
            "city": "STICKNEY",
            "state": "IL",
            "postal_code": "604024174",
            "telephone_number": "708-788-9100",
            "fax_number": "708-788-4856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6721 40TH ST",
            "city": "STICKNEY",
            "state": "IL",
            "postal_code": "604024174",
            "telephone_number": "708-788-9100",
            "fax_number": "708-788-4856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STICKNEY PUBLIC HEALTH DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-14",
        "last_updated": "2011-07-14",
        "status": "A",
        "authorized_official_last_name": "GRUNOW",
        "authorized_official_first_name": "CHISTOPHER",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "708-424-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stickney, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; 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.