Tiffany CHI Mateo, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

036.142627 Issued in IL

Practice address

1875 W Dempster St
Ste. 470
Park Ridge, IL 60068-1186

Phone

(847) 795-5865

NPI assigned

Mar 23, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Tiffany Michelle CHI Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Edgewood Clinical Services, P.C.

  • Psychologist
  • Naperville, IL
  • NPI 1295914646
  NPD
• Edgewood Clinical Services, P.C.

  • Community/Behavioral Health Agency
  • Naperville, IL
  • NPI 1366784837
  NPD

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

{
    "created_epoch": "1395532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498089600000",
    "number": "1508283078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123706",
            "telephone_number": "314-677-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 W DEMPSTER ST",
            "address_2": "STE. 470",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681186",
            "telephone_number": "847-795-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEO",
        "first_name": "TIFFANY",
        "middle_name": "CHI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-23",
        "last_updated": "2017-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036.142627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "CHI",
            "middle_name": "MICHELLE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daria Maslankiewicz, PTA
• Sarah Masse
• Teresa C Massimini-Chilla, OTR/L
• Maliha Masud, MD
• Angelika Matecki, DNP
• Annette Mathew, DO
• Maya Mathews
• Julia Marie Matson, LCSW
• Jean M Mau, ADVANCED PRACTICE NU
• Jessica Mauleon, DNP, NP-C

• Child & Adolescent Psychiatry Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Child & Adolescent Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.