NPIMap

Organization Active NPI

Neuropsychiatric Services SC

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1518131002
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036085219 Issued in IL
Legal business name
NEUROPSYCHIATRIC SERVICES SC
Practice address
1044 N Francisco Ave Ste 403
Chicago, IL 60622-2743
Phone
(847) 212-9809
NPI assigned
Apr 16, 2008
Last updated
Aug 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Authorized official

Name
Jacinto Antonio V Dizon, M.D.NPI 1669510954
Title
President
Phone
(847) 212-9809

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036085219 IL Primary

Addresses

Primary practice location

1044 N Francisco Ave Ste 403
Chicago, IL 60622-2743

Mailing address

1211 S Prairie Ave
Suite 5505
Chicago, IL 60605-3645
Phone (847) 212-9809

Other practice location 1

1211 S Prairie Ave
Suite 5505
Chicago, IL 60605
Phone (847) 212-9809

Other identifiers 1

IdentifierTypeStateIssuer
36085219MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041008000639 IL Part B Supplier - Clinic/Group Practice 3779542287 Receives reassigned benefits from 14 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

1044 N Francisco Ave
Ste 403
Chicago, IL 60622
Phone (847) 212-9809

2450 N Central Ave
Chicago, IL 60639
Phone (773) 889-1333

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1518131002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 S PRAIRIE AVE",
            "address_2": "SUITE 5505",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053645",
            "telephone_number": "847-212-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 N FRANCISCO AVE STE 403",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222743",
            "telephone_number": "847-212-9809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1211 S Prairie Ave",
            "address_2": "Suite 5505",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60605",
            "country_code": "US",
            "telephone_number": "847-212-9809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEUROPSYCHIATRIC SERVICES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-16",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "DIZON",
        "authorized_official_first_name": "JACINTO",
        "authorized_official_middle_name": "ANTONIO V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-212-9809",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036085219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36085219",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.