NPIMap

Organization Active NPI

Illinois Department of Human Services

Doing business as Elgin Mental Health Center

  • Psychiatric Hospital
  • Elgin, IL
National Provider Identifier
1639221302
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Doing business as
Elgin Mental Health Center
Practice address
750 S State St
Elgin, IL 60123-7612
Phone
(847) 742-1040
Fax
(847) 429-4910
NPI assigned
Jan 16, 2007
Last updated
Apr 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
Mr. Raul Almazar, R.N., M.A.
Title
Hospital Administrator
Phone
(847) 742-1040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X NU Primary

Addresses

Primary practice location

750 S State St
Elgin, IL 60123-7612

Mailing address

750 S State St
Elgin, IL 60123-7612
Phone (847) 742-1040

Other names 1

  • Elgin Mental Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031113000414 IL Part B Supplier - Clinic/Group Practice 9830003920 Receives reassigned benefits from 43 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Centralia, IL; Waukegan, IL; Park Forest, IL; Kankakee, IL; Hines, IL; Dwight, IL; Dixon, IL; Chicago, IL…
O20080407000101 IL Part A Provider - Hospital 9830003920 Practice locations: Elgin, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639221302. Details of each certification follow.

Hospital certification: CCN 144037

Legal name
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Doing business as
ELGIN MENTAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Mar 11, 1998
Last certification
May 5, 2022
Beds
582 (53 certified)
Ownership / control type
State
Organization structure
GovernmentNon-profit
Enrollment address
750S State St
Elgin, IL 60123-7612
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

Care Compare: Hospital

Medicare Care Compare
Listed as
Elgin Mental Health CenterCCN 144037 · All quality measures
Type
Psychiatric
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Victoria Pyles Individual Corporate Officer Jul 1, 2016
Mark a Bartolozzi Individual Corporate Director Jul 16, 2016
W-2 Managing Employee Jul 16, 2016
Illinois Department of Human Services Organization, Springfield, IL 5% Or Greater Direct Ownership Interest Jul 1, 1975 100%

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Chicago Read Mental Health CenterChicago, IL, CCN 144010 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1970
Elizabeth Parsons Ware Packard Mental Health CenterSpringfield, IL, CCN 144021 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1975
Alton Mental Health CenterAlton, IL, CCN 144016 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 1, 1996
John J Madden Mental Health CenterHines, IL, CCN 144028 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1975

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

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": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1639221302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 S STATE ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237612",
            "telephone_number": "847-742-1040",
            "fax_number": "847-429-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 S STATE ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237612",
            "telephone_number": "847-742-1040",
            "fax_number": "847-429-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS DEPARTMENT OF HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "ALMAZAR",
        "authorized_official_first_name": "RAUL",
        "authorized_official_title_or_position": "HOSPITAL ADMINISTRATOR",
        "authorized_official_telephone_number": "847-742-1040",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.N., M.A."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elgin Mental Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.