NPIMap

Organization Active NPI

Midwest Counseling and Diagnostic Center

  • Addiction (Substance Use Disorder) Counselor
  • Chicago, IL
National Provider Identifier
1679914584
Registry record updated Jul 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
MIDWEST COUNSELING AND DIAGNOSTIC CENTER
Practice address
2955 W Eastwood Ave
Chicago, IL 60625-3721
Phone
(312) 543-4792
NPI assigned
Jul 9, 2013
Last updated
Jul 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2013

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

Authorized official

Name
Christian M Ryba, J.D.
Title
Business Manager
Phone
(312) 543-4792

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU Primary

Addresses

Primary practice location

2955 W Eastwood Ave
Chicago, IL 60625-3721

Mailing address

2955 W Eastwood Ave
Chicago, IL 60625-3721

National Provider Directory

National Provider Directory

Locations

1 E Wacker Dr
Ste 2300
Chicago, IL 60601
Phone (312) 291-9570

Practitioners & affiliated clinicians

Practitioners 6

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": "1373328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373328000000",
    "number": "1679914584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 W EASTWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 W EASTWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253721",
            "telephone_number": "312-543-4792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST COUNSELING AND DIAGNOSTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-09",
        "last_updated": "2013-07-09",
        "status": "A",
        "authorized_official_last_name": "RYBA",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "312-543-4792",
        "authorized_official_credential": "J.D."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; 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.