Illinois Institute for Integrative Mental Health LTD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036100514 Issued in IL

Legal business name

ILLINOIS INSTITUTE FOR INTEGRATIVE MENTAL HEALTH LTD

Practice address

4770 N Lincoln Ave Ste 7
Chicago, IL 60625-1056

Phone

(312) 342-0312

NPI assigned

Jun 5, 2007

Organization subpart

No

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

Authorized official

Name

Eldin Dzudza, MD

Title

President

Phone

(312) 342-0312

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1467655894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W SUPERIOR ST APT 504",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606107655",
            "telephone_number": "312-342-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 N LINCOLN AVE STE 7",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251056",
            "telephone_number": "312-342-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS INSTITUTE FOR INTEGRATIVE MENTAL HEALTH LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "DZUDZA",
        "authorized_official_first_name": "ELDIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-342-0312",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036100514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.