NPIMap

Organization Active NPI

Presence Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Evanston, IL
National Provider Identifier
1659527208
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
PRESENCE BEHAVIORAL HEALTH
Practice address
355 Ridge Ave
Evanston, IL 60202-3328
Phone
(708) 338-3806
Fax
(708) 345-5496
NPI assigned
Aug 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Authorized official

Name
Mrs. Kristin Kaminski
Title
Manager, General Accounting
Phone
(708) 338-3806

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X IL Primary

Addresses

Primary practice location

355 Ridge Ave
Evanston, IL 60202-3328

Mailing address

1820 S 25TH Ave
Broadview, IL 60155-2864
Phone (708) 338-3806

Other identifiers 1

IdentifierTypeStateIssuer
1616027OtherILBCBS

Other names 1

  • ProCare Centers Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Presence Behavioral Health26 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

NPI Registry JSON

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1659527208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 S 25TH AVE",
            "city": "BROADVIEW",
            "state": "IL",
            "postal_code": "601552864",
            "telephone_number": "708-338-3806",
            "fax_number": "708-681-1289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023328",
            "telephone_number": "708-338-3806",
            "fax_number": "708-345-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-14",
        "last_updated": "2016-07-27",
        "status": "A",
        "authorized_official_last_name": "KAMINSKI",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "MANAGER, GENERAL ACCOUNTING",
        "authorized_official_telephone_number": "708-338-3806",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1616027",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProCare Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.