Individual provider Active NPI

Elizabeth Charney

  • Child & Adolescent Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1497767719
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Practice address
1747 W Roosevelt Rd
Chicago, IL 60608-1264
Phone
(312) 996-7223
Fax
(312) 996-9788
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X IL Primary

Addresses

Primary practice location

1747 W Roosevelt Rd
Chicago, IL 60608-1264

Mailing address

912 S Wood St
Chicago, IL 60612-4300
Phone (312) 996-7206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130716000895 IL Practitioner - Psychiatry 2264672179 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Aug 27, 2018 Accepting new patients
The Board of Trustees of the University of Illinois Child & Adolescent Psychiatry CurrentSince Aug 27, 2018 Accepting new patients
The Board of Trustees of the University of Illinois Past Accepting new patients

Locations

7825 Solution Ctr
Chicago, IL 60677

912 S Wood St
Chicago, IL 60612
Phone (312) 996-2200

835 S Wolcott Ave
Rm W140
Chicago, IL 60612

1747 W Roosevelt Rd
Chicago, IL 60608
Phone (312) 996-2200

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497767719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 S WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124300",
            "telephone_number": "312-996-7206",
            "fax_number": "312-996-9788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 W ROOSEVELT RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081264",
            "telephone_number": "312-996-7223",
            "fax_number": "312-996-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARNEY",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.