NPIMap

Organization Active NPI

Kenneth Young Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Elk Grove Village, IL
National Provider Identifier
1629083241
Registry record updated Aug 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
KENNETH YOUNG CENTER
Practice address
1001 Rohlwing Rd
Elk Grove Village, IL 60007-3217
Phone
(847) 524-8800
Fax
(847) 524-8824
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2017

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

Authorized official

Name
James Bruski
Title
Human Resources Manager
Phone
(847) 524-8800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1001 Rohlwing Rd
Elk Grove Village, IL 60007-3217

Mailing address

1001 Rohlwing Rd
Elk Grove Village, IL 60007-3217
Phone (847) 524-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041109000272 IL Part B Supplier - Clinic/Group Practice 7416940655 Receives reassigned benefits from 35 practitioners
Practice locations: Elk Grove Village, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 36

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.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502323200000",
    "number": "1629083241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 ROHLWING RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073217",
            "telephone_number": "847-524-8800",
            "fax_number": "847-524-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 ROHLWING RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073217",
            "telephone_number": "847-524-8800",
            "fax_number": "847-524-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH YOUNG CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2017-08-10",
        "status": "A",
        "authorized_official_last_name": "BRUSKI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "HUMAN RESOURCES MANAGER",
        "authorized_official_telephone_number": "847-524-8800"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.