NPIMap

Organization Active NPI

Advanced Psychiatry of Elgin

  • Behavior Analyst
  • Elgin, IL
National Provider Identifier
1588069306
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
036111811 Issued in IL
Legal business name
ADVANCED PSYCHIATRY OF ELGIN
Practice address
2130 Point Blvd
Suite 200
Elgin, IL 60123-9215
Phone
(847) 783-0307
NPI assigned
Oct 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Authorized official

Name
Aleatha Howen
Title
Office Manager
Phone
(847) 783-0307

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 036111811 IL Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 149004898 IL
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 149016112 IL

Addresses

Primary practice location

2130 Point Blvd
Suite 200
Elgin, IL 60123-9215

Mailing address

2130 Point Blvd
Suite 200
Elgin, IL 60123-9215
Phone (847) 783-0307

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2076554Advanced Psychiatry of Elgin2130 Point Blvd, Ste 200, Elgin, IL 60123Certificate of waiverApr 21, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414022400000",
    "number": "1588069306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 POINT BLVD",
            "address_2": "SUITE 200",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601239215",
            "telephone_number": "847-783-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 POINT BLVD",
            "address_2": "SUITE 200",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601239215",
            "telephone_number": "847-783-0307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PSYCHIATRY OF ELGIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A",
        "authorized_official_last_name": "HOWEN",
        "authorized_official_first_name": "ALEATHA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-783-0307"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "036111811",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149004898",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149016112",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.