Individual provider Active NPI

Raymond Bryant, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1609354133
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209.017627 Issued in IL
Practice address
850 W Irving Park Rd
Chicago, IL 60613-3077
Phone
(312) 888-2986
NPI assigned
Aug 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.017627 IL Primary

Addresses

Primary practice location

850 W Irving Park Rd
Chicago, IL 60613-3077

Mailing address

4050 Healthway Dr Ste 140
Aurora, IL 60504-8184
Phone (630) 549-5429

Other practice location 1

2081 Calistoga Dr Ste 2S
New Lenox, IL 60451-4833
Phone (815) 418-6070

Other practice location 2

4050 Healthway Dr Ste 140
Aurora, IL 60504-8184
Phone (630) 549-5429

Other identifiers 1

IdentifierTypeStateIssuer
2018001305OtherILANCC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190308002759 IL Practitioner - Nurse Practitioner 7911246996 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Silver Oaks Behavioral, LLCGroup PAC ID 4183976434, 11 clinicians
Tabs Behavioral Health IncGroup PAC ID 7517344633, 9 clinicians
Ranganathan T LTDGroup PAC ID 4284060484, 5 clinicians

Practice addresses (Care Compare)

1004 Pawlak Pkwy
New Lenox, IL 60451-9401
Phone (844) 580-5000

4050 Healthway Dr
Suite 140
Aurora, IL 60504-8184
Phone (815) 409-5117

555 Wilson LN
Des Plaines, IL 60016-4729
Phone (248) 699-7850

Hospital & facility affiliations

  • Loretto Hospital Hospital, Chicago, IL, CCN 140083
  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.017627ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
2014 Health, LLC CurrentSince Apr 14, 2020 Accepting new patients
Tabs Behavioral Health Inc Psychiatric/Mental Health CurrentSince Jan 11, 2019 Accepting new patients
Ranganathan T LTD CurrentSince May 1, 2020 Accepting new patients
Metropolitan Behavioral Associates, Inc. CurrentSince Dec 26, 2018 Accepting new patients
Mindwell Inc CurrentSince Jul 1, 2020 Accepting new patients
MD Medical, LLC CurrentSince Jan 5, 2019 Accepting new patients
Silver Oaks Behavioral, LLC CurrentSince Nov 29, 2021 Accepting new patients
Connections Medical Group Associates LLC PastSince Apr 7, 2022 Accepting new patients

Locations

4050 Healthway Dr
Ste 140
Aurora, IL 60504
Phone (630) 318-3355

645 S Central Ave
Chicago, IL 60644
Phone (773) 626-4300

555 Wilson Ln
Des Plaines, IL 60016
Phone (212) 243-5565

1004 Pawlak Pkwy
New Lenox, IL 60451
Phone (815) 215-3300

915 Harger Rd
Ste 101
Oak Brook, IL 60523
Phone (708) 328-3225

Interoperability endpoints

  • Direct secure messaging: rbryant259226@uchospital.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1609354133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 HEALTHWAY DR STE 140",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605048184",
            "telephone_number": "630-549-5429",
            "fax_number": "773-912-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133077",
            "telephone_number": "312-888-2986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2081 Calistoga Dr Ste 2S",
            "address_purpose": "LOCATION",
            "city": "New Lenox",
            "state": "IL",
            "postal_code": "604514833",
            "country_code": "US",
            "telephone_number": "815-418-6070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4050 Healthway Dr Ste 140",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605048184",
            "country_code": "US",
            "telephone_number": "630-549-5429",
            "fax_number": "773-912-6727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "RAYMOND",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-06",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.017627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC",
            "identifier": "2018001305",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.