Beverly Psychiatric Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

BEVERLY PSYCHIATRIC SERVICES LLC

Practice address

10406 S Western Ave
Chicago, IL 60643-2508

Phone

(312) 857-4475

Fax

(773) 666-7241

NPI assigned

Feb 12, 2024

Last updated

Sep 2, 2025By 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

Douglas O Nyenke, APN, PMHNP-BCNPI 1780399055

Title

Provider/Owner

Phone

(312) 857-4475

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 4

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.

• Douglas Nyenke, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
  • NPI 1780399055
  Medicare reassignment NPD Authorized official
• Gifty Serwaa Danso

  • Psychiatric/Mental Health Nurse Practitioner
  • Aurora, IL
  • NPI 1255129763
  Medicare reassignment NPD
• Latoya Robinson, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
  • NPI 1407223258
  Medicare reassignment NPD
• Chartiece Walker

  • Psychiatric/Mental Health Nurse Practitioner
  • Lynwood, IL
  • NPI 1184595647
  Medicare reassignment

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1659135416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10406 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432508",
            "telephone_number": "312-857-4475",
            "fax_number": "773-666-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10406 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432508",
            "telephone_number": "312-857-4475",
            "fax_number": "773-666-7241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY PSYCHIATRIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-12",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A",
        "authorized_official_last_name": "NYENKE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "312-857-4475",
        "authorized_official_credential": "APN, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.