NPIMap

Organization Active NPI

Pilsen-Little Village Community Mental Health Center, Inc.

Doing business as Pilsen Wellness Center, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Chicago, IL
National Provider Identifier
1568839090
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
PILSEN-LITTLE VILLAGE COMMUNITY MENTAL HEALTH CENTER, INC.
Doing business as
Pilsen Wellness Center, Inc
Practice address
3232 W 55TH St
Chicago, IL 60632-2638
Phone
(773) 424-3060
Fax
(773) 424-3368
NPI assigned
Sep 1, 2015
Last updated
Jun 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

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

Authorized official

Name
Dr. Francisco Cisneros
Title
Presicent/Ceo
Phone
(773) 579-0832

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

3232 W 55TH St
Chicago, IL 60632-2638

Mailing address

2319 S Damen Ave
Chicago, IL 60608-4209
Phone (773) 579-0832

Other names 1

  • Pilsen Wellness Center, Inc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pilsen Wellness Center Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559865600000",
    "number": "1568839090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2319 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084209",
            "telephone_number": "773-579-0832",
            "fax_number": "773-579-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3232 W 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606322638",
            "telephone_number": "773-424-3060",
            "fax_number": "773-424-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PILSEN-LITTLE VILLAGE COMMUNITY MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-01",
        "last_updated": "2019-06-07",
        "status": "A",
        "authorized_official_last_name": "CISNEROS",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_title_or_position": "PRESICENT/CEO",
        "authorized_official_telephone_number": "773-579-0832",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pilsen Wellness Center, Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pilsen Wellness Center, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 7, 2019; 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.