Specialized Forensic Unit PC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

SPECIALIZED FORENSIC UNIT PC

Practice address

1005 N Western Ave Unit 1
Chicago, IL 60622-6224

Phone

(800) 488-9790

NPI assigned

Oct 12, 2023

Last updated

Oct 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tetyana KostyshynaNPI 1083168041

Title

Ceo

Phone

(800) 488-2604

Specialties & licenses 2

Addresses

Tax ID family

Specialized Forensic Unit PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Specialized Forensic Unit PC

  • Adolescent and Children Mental Health Clinic/Center
  • St Charles, IL
  • NPI 1396283768
  NPD tax ID

Locations

Practitioners 1

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.

• Tetyana Kostyshyna, PSYD, LCPC, LSOE/TP

  • Clinical Psychologist
  • St Charles, IL
  • NPI 1083168041
  NPD Authorized official

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1619758836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N 2ND ST STE 22",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741804",
            "telephone_number": "312-818-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 N WESTERN AVE UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606226224",
            "telephone_number": "800-488-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED FORENSIC UNIT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "KOSTYSHYNA",
        "authorized_official_first_name": "TETYANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "800-488-2604"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Special Therapy Care, Inc.
• Specialized Assessilng Systems Institute, Corp (SASI Corp)
• Specialized Assessing Systems Institute, Corp (SASI, Elwood P Nyther)
• Specialized Assistance Recovery LLC
• Specialized Assistance Services, NFP
• Specialized Health Care Services Inc.
• Specialized Healthcare Services Inc
• Specialized Medical Care, LLC
• Specialized PT PLLC
• Specialty Care RX LLC (Curexa)

• Adolescent and Children Mental Health Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Adolescent and Children Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.