Active NPI
Carol Lynn Childers, M.D.
- Addiction Medicine (Psychiatry & Neurology) Physician
- Chicago, IL
National Provider Identifier
1700086220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Psychiatry & Neurology) Physician
- Practice address
- 25 E Washington St
#1726
Chicago, IL 60602-1708 - Phone
- (312) 346-3670
- Fax
- (312) 787-3654
- NPI assigned
- Jul 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | IL | Primary |
Addresses
Primary practice location
25 E Washington St
#1726
Chicago, IL 60602-1708
Mailing address
25 E Washington St
#1726
Chicago, IL 60602-1708
Phone (312) 346-3670
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185148800000",
"number": "1700086220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 E WASHINGTON ST",
"address_2": "#1726",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606021708",
"telephone_number": "312-346-3670",
"fax_number": "312-787-3654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 E WASHINGTON ST",
"address_2": "#1726",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606021708",
"telephone_number": "312-346-3670",
"fax_number": "312-787-3654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILDERS",
"first_name": "CAROL",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-23",
"last_updated": "2007-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084A0401X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
- Child and Family Treatment, LLC
- Child Family Center for Health Wellbeing LTD (The Nest)
- Child Link Inc
- Child Study Center
- Child, Adolescent, & Adult Psychiatry SC
- Sara Childers, MD
- Children and Families First
- Children and Families Support Services P.C.
- Children's Dental World, LLC
- Children's Healthcare Associates P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.