NPIMap

Organization Active NPI

McDermott Center

Doing business as Haymarket Center

  • Substance Abuse Rehabilitation Facility
  • Chicago, IL
National Provider Identifier
1619355542
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
A-0349-0037 Issued in IL
Legal business name
MCDERMOTT CENTER
Doing business as
Haymarket Center
Practice address
4753 N Broadway St
Suite 612
Chicago, IL 60640-5266
Phone
(312) 226-7984
Fax
(312) 226-8048
NPI assigned
May 12, 2015
Last updated
Aug 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Authorized official

Name
Dr. Dan Lustig
Title
President & Ceo
Phone
(312) 226-7984

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X A-0349-0037 IL Primary

Addresses

Primary practice location

4753 N Broadway St
Suite 612
Chicago, IL 60640-5266

Mailing address

932 W Washington Blvd
Chicago, IL 60607-2217
Phone (312) 226-7984

Other names 1

  • Haymarket Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Haymarket House26 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

Locations

4753 N Broadway St
Ste 612
Chicago, IL 60640
Phone (773) 271-8284

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628208000000",
    "number": "1619355542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 W WASHINGTON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072217",
            "telephone_number": "312-226-7984",
            "fax_number": "312-226-8048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4753 N BROADWAY ST",
            "address_2": "SUITE 612",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405266",
            "telephone_number": "312-226-7984",
            "fax_number": "312-226-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDERMOTT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-12",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A",
        "authorized_official_last_name": "LUSTIG",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "312-226-7984",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "IL",
            "license": "A-0349-0037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haymarket Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Haymarket 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 Aug 6, 2021; 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.