NPIMap

Organization Active NPI

Dr. Mendenhall

  • Community/Behavioral Health Agency
  • Chicago, IL
National Provider Identifier
1720453947
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
180.007149 Issued in IL
Legal business name
DR. MENDENHALL
Practice address
8104 S Kingston Ave
Chicago, IL 60617-1231
Phone
(773) 434-6715
NPI assigned
Dec 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Authorized official

Name
Ms. Denise Smith
Title
Senior Biller/ Exec. Asst.
Phone
(331) 643-5238

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 21415 IL
Community/Behavioral Health Agency 251S00000X 180.007149 IL Primary

Addresses

Primary practice location

8104 S Kingston Ave
Chicago, IL 60617-1231

Mailing address

8104 S Kingston Ave
Chicago, IL 60617-1231
Phone (773) 434-6715

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450051200000",
    "number": "1720453947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8104 S KINGSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606171231",
            "telephone_number": "773-434-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8104 S KINGSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606171231",
            "telephone_number": "773-434-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MENDENHALL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-14",
        "last_updated": "2015-12-14",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "SENIOR BILLER/ EXEC. ASST.",
        "authorized_official_telephone_number": "331-643-5238",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "21415",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "180.007149",
            "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 Dec 14, 2015; 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.