NPIMap

Organization Active NPI

Rincon Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
National Provider Identifier
1558710384
Registry record updated Nov 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
RINCON FAMILY SERVICES
Practice address
5453 W Diversey Ave
Chicago, IL 60639-1413
Phone
(888) 215-0513
NPI assigned
Jun 13, 2016
Last updated
Nov 1, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2018

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

Authorized official

Name
Mr. Eddy Borrayo
Title
President/Ceo
Phone
(773) 564-9070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

5453 W Diversey Ave
Chicago, IL 60639-1413

Mailing address

3710 N Kedzie Ave
Chicago, IL 60618-4504
Phone (773) 564-9070

Other identifiers 1

IdentifierTypeStateIssuer
14003MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Rincon Family Services21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541030400000",
    "number": "1558710384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 N KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184504",
            "telephone_number": "773-564-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5453 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391413",
            "telephone_number": "888-215-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RINCON FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2018-11-01",
        "status": "A",
        "authorized_official_last_name": "BORRAYO",
        "authorized_official_first_name": "EDDY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "773-564-9070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14003",
            "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 Nov 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.