Acute Mantis Care

Organization Active NPI Adult Mental Health Clinic/Center · Niles, IL

NPI 1467053306 · NPPES record last updated Oct 17, 2023

Key facts

NPI
1467053306
Entity type
Organization (NPI type 2)
Primary specialty
Adult Mental Health Clinic/Center 261QM0850X
Legal business name
ACUTE MANTIS CARE
Practice address
7800 N Milwaukee Ave
Niles, IL 60714-3124
Phone
(312) 809-0777
Fax
(773) 492-8783
NPI assigned
Nov 6, 2020
Organization subpart
No

Authorized official

Name
Elena Tiran
Title
President
Phone
(773) 541-1826

Practitioners 3

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210222001414 IL Part B Supplier - Clinic/Group Practice 1850706052 Receives reassigned benefits from 1 practitioner
Practice locations: Niles, IL

National Provider Directory

Locations

6050 N California Ave
Ste 101
Chicago, IL 60659
Phone (312) 809-0777

6050 N California Ave
Chicago, IL 60659
Phone (847) 675-6093

7800 N Milwaukee Ave
Niles, IL 60714
Phone (312) 809-0777

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Adult Mental Health Clinic/Center 261QM0850X Yes

Addresses

Primary practice location

7800 N Milwaukee Ave
Niles, IL 60714-3124

Mailing address

6050 N California Ave
Chicago, IL 60659-3916
Phone (312) 809-0777

Other providers in Niles, IL

All providers in Niles, IL · Adult Mental Health Clinic/Center in Illinois

Sources for this page

Verify at the official NPI Registry.