NPIMap

Organization Active NPI

Gottlieb Community Health Services Corporation

  • Psychiatric Hospital Unit
  • Berwyn, IL
National Provider Identifier
1700864352
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
0005082 Issued in IL
Legal business name
GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION
Practice address
3249 South Oak Park Ave
Berwyn, IL 60402
Phone
(708) 783-3222
Fax
(708) 783-3489
NPI assigned
Jan 4, 2006
Last updated
Jun 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Authorized official

Name
Adenrele Kolawole
Title
Director Billing and Collections
Phone
(708) 216-3743

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 0005082 IL Primary

Addresses

Primary practice location

3249 South Oak Park Ave
Berwyn, IL 60402

Mailing address

3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (615) 665-6000

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250714000498 IL Part A Provider - Hospital 3375442999 Practice locations: Berwyn, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700864352. Details of each certification follow.

Hospital certification: CCN 14S054

Legal name
GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION
Doing business as
MACNEAL HOSPITAL
Organization structure
CorporationNon-profit
Enrollment address
3249 Oak Park Ave
Berwyn, IL 60402-3429
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

100 Falls Canyon Rd
Avalon, CA 90704
Phone (310) 510-0700

1223 16th St
Ste 3400
Santa Monica, CA 90404
Phone (310) 319-4080

7107 W Belmont Ave
Ste 7
Chicago, IL 60634
Phone (773) 456-7587

2930 Mannheim Rd
Franklin Park, IL 60131
Phone (708) 798-0800

675 W North Ave
Ste 306
Melrose Park, IL 60160
Phone (708) 681-9210

701 W North Ave
Fl First
Melrose Park, IL 60160
Phone (708) 681-7373

1100 Lake St
Ste 150
Oak Park, IL 60301
Phone (708) 383-2023

8488 Grand Ave
River Grove, IL 60171
Phone (708) 456-4944

3722 Harlem Ave
Ste 100
Riverside, IL 60546
Phone (708) 783-2970

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Charles Bareis Individual Corporate OfficerPresident May 3, 2025
Corporate DirectorBoard Member Jan 1, 2026
Elizabeth Early Individual Corporate DirectorBoard Member Jan 1, 2022
Eva Maria Wojcik Individual Corporate DirectorBoard Member Jan 1, 2022
Sarah Hunter Individual Corporate DirectorBoard Member Jan 1, 2026
Melissa Lukasick Individual Corporate OfficerTreasurer Jan 1, 2022
Bertina Barnes Individual Corporate OfficerAsst Secretary Jan 1, 2024
Marc H Schwartz Individual Corporate OfficerBoard Chair Jan 1, 2022
Corporate DirectorBoard Member Jan 1, 2022
Maria J Pekar Individual Corporate OfficerAsst Secretary Jan 1, 2022
Joy V Cunningham Individual Corporate DirectorBoard Member Jan 1, 2022
Juan Gaytan Individual Corporate DirectorBoard Member Mar 28, 2025
Jill Rappis Individual Corporate OfficerSecretary Jan 1, 2022
Adenrele Adekunbi Kolawole Individual Corporate OfficerDirector Central Billing Operations Jan 1, 2022
Operational/Managerial ControlExecutive With Control Jan 1, 2022
Loyola University Health System Organization, Maywood, IL Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 1, 2008 100%
Trinity Health Corporation Organization, Livonia, MI Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Jul 1, 2011 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 157

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 157

Practitioners & affiliated clinicians

Practitioners 136

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.

View all 136

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750032000000",
    "number": "1700864352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3249 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023429",
            "telephone_number": "615-665-6000",
            "fax_number": "615-665-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3249 SOUTH OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "60402",
            "telephone_number": "708-783-3222",
            "fax_number": "708-783-3489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-04",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A",
        "authorized_official_last_name": "KOLAWOLE",
        "authorized_official_first_name": "ADENRELE",
        "authorized_official_title_or_position": "DIRECTOR BILLING AND COLLECTIONS",
        "authorized_official_telephone_number": "708-216-3743"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "IL",
            "license": "0005082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.