Midwest Brain Injury Clubhouse

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MIDWEST BRAIN INJURY CLUBHOUSE

Practice address

1021 W Adams St.
Suite 200
Chicago, IL 60607-2936

Phone

(312) 226-8720

Fax

(312) 226-8722

NPI assigned

Oct 14, 2014

Organization subpart

No

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

Authorized official

Name

Tammiko Bess

Title

Executive Director

Phone

(312) 226-8714

Specialties & licenses 10

Addresses

Tax ID family

Midwest Brain Injury Clubhouse2 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.

• Midwest Brain Injury Clubhouse

  • Voluntary or Charitable Agency
  • Chicago, IL
  • NPI 1275647315
  NPD tax ID

Locations

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1669876033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W ADAMS ST STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072936",
            "telephone_number": "312-226-8720",
            "fax_number": "312-226-8722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 W ADAMS ST.",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072936",
            "telephone_number": "312-226-8720",
            "fax_number": "312-226-8722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST BRAIN INJURY CLUBHOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-14",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "BESS",
        "authorized_official_first_name": "TAMMIKO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "312-226-8714"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midwest Asian Health Association
• Midwest Associates in Primary Care LTD
• Midwest Back Center
• Midwest Behavioral Associates LLC
• Midwest Brain Injury Clubhouse
• Midwest Cardiac Center SC
• Midwest Care, Inc. (Kin Care, Inc.)
• Midwest Care, Inc. Dba Kin Care, Inc.
• Midwest Chest Consultants LLC
• Midwest Counseling and Diagnostic Center

• Community/Behavioral Health Agency in Chicago, IL
• Providers in Chicago, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.