Center for Integrative Psychiatry LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

CENTER FOR INTEGRATIVE PSYCHIATRY LLC

Practice address

8745 W Higgins Rd Ste 110
Chicago, IL 60631-2753

Phone

(224) 361-3301

Fax

(405) 337-9658

NPI assigned

Mar 11, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Bernadette Mietus Stevenson, MD, PHDNPI 1134347909

Title

Owner

Phone

(224) 361-3301

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Bernadette Mietus Stevenson, M.D., PHD

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1134347909
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682208000000",
    "number": "1477011310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8745 W HIGGINS RD STE 110",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606312753",
            "telephone_number": "224-361-3301",
            "fax_number": "405-337-9658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8745 W HIGGINS RD STE 110",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606312753",
            "telephone_number": "224-361-3301",
            "fax_number": "405-337-9658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 S Northwest Hwy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600684262",
            "country_code": "US",
            "telephone_number": "224-361-3301",
            "fax_number": "405-337-9658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTER FOR INTEGRATIVE PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-11",
        "last_updated": "2023-04-23",
        "certification_date": "2023-04-23",
        "status": "A",
        "authorized_official_last_name": "STEVENSON",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_middle_name": "MIETUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-361-3301",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "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 Apr 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.