NPIMap

Organization Active NPI

Brighthouse Diagnostics, LLC

Doing business as Brighthouse Diagnostics and Treatment Center

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1598221996
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
BRIGHTHOUSE DIAGNOSTICS, LLC
Doing business as
Brighthouse Diagnostics and Treatment Center
Practice address
2919 N Southport Ave Apt 1
Chicago, IL 60657-7387
Phone
(920) 474-5044
NPI assigned
Feb 11, 2019
Last updated
Sep 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Authorized official

Name
Dr. Saira Aslam Khan, PSYDNPI 1043658099
Title
Clinical Psychologist
Phone
(773) 799-8939

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
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

2919 N Southport Ave Apt 1
Chicago, IL 60657-7387

Mailing address

2919 N Southport Ave Apt 1
Chicago, IL 60657-7387

Other names 1

  • Brighthouse Diagnostics and Treatment Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1598221996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 N SOUTHPORT AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 N SOUTHPORT AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577387",
            "telephone_number": "920-474-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTHOUSE DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-11",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SAIRA",
        "authorized_official_middle_name": "ASLAM",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "773-799-8939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brighthouse Diagnostics and Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brighthouse Diagnostics and Treatment Center",
            "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 Sep 16, 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.