NPIMap

Organization Active NPI

Valley Psychiatry and Counseling, LLC

  • Psychiatry Physician
  • Elgin, IL
National Provider Identifier
1497082770
Registry record updated Nov 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036-119726 Issued in IL
Legal business name
VALLEY PSYCHIATRY AND COUNSELING, LLC
Practice address
75 Market St
Suite 14
Elgin, IL 60123-5093
Phone
(847) 697-6290
Fax
(847) 697-0252
NPI assigned
Nov 8, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2009

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

Authorized official

Name
Dr. Syed Waliuddin, M.D.NPI 1104046630
Title
Manager
Phone
(847) 697-6290

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 036-119726 IL Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X 036-119726 IL

Addresses

Primary practice location

75 Market St
Suite 14
Elgin, IL 60123-5093

Mailing address

75 Market St
Suite 14
Elgin, IL 60123-5093
Phone (847) 697-6290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100430000430 IL Part B Supplier - Clinic/Group Practice 8921135518 Receives reassigned benefits from 3 practitioners
Practice locations: Elgin, IL

National Provider Directory

National Provider Directory

Locations

75 Market St
Ste 12
Elgin, IL 60123
Phone (847) 695-6955

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1257638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257638400000",
    "number": "1497082770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MARKET ST",
            "address_2": "SUITE 14",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235093",
            "telephone_number": "847-697-6290",
            "fax_number": "847-697-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MARKET ST",
            "address_2": "SUITE 14",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235093",
            "telephone_number": "847-697-6290",
            "fax_number": "847-697-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY PSYCHIATRY AND COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-08",
        "last_updated": "2009-11-08",
        "status": "A",
        "authorized_official_last_name": "WALIUDDIN",
        "authorized_official_first_name": "SYED",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-697-6290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-119726",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036-119726",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2009; 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.