NPIMap

Organization Active NPI

Maryville Academy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Des Plaines, IL
National Provider Identifier
1467909275
Registry record updated Jul 8, 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
701 Lee St Ste 100
Des Plaines, IL 60016-4543
Phone
(847) 390-3004
Fax
(847) 390-3016
NPI assigned
Sep 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Authorized official

Name
Sr. Catherine M Ryan
Title
Executive Director
Phone
(847) 294-1893

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X IL
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

701 Lee St Ste 100
Des Plaines, IL 60016-4543

Mailing address

701 Lee St Ste 100
Des Plaines, IL 60016-4543
Phone (847) 390-3004

Other names 1

  • Family Behavioral Health Clinic Doing business as

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

1455 E Golf Rd
Ste 210
Des Plaines, IL 60016

NPI Registry JSON

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

{
    "created_epoch": "1473379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657238400000",
    "number": "1467909275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 LEE ST STE 100",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600164543",
            "telephone_number": "847-390-3004",
            "fax_number": "847-390-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 LEE ST STE 100",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600164543",
            "telephone_number": "847-390-3004",
            "fax_number": "847-390-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYVILLE ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-09",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "SR. CATHERINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "847-294-1893"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": "IL",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Behavioral Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Behavioral Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.