Organization Active NPI

Psychiatry Specialists P.C.

  • Mental Illness Community Based Residential Treatment Facility
  • Chicago, IL
National Provider Identifier
1730468307
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
PSYCHIATRY SPECIALISTS P.C.
Practice address
4535 N Beacon St
Chicago, IL 60640-5518
Phone
(773) 629-0716
NPI assigned
Aug 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Authorized official

Name
Stacy Cloyd
Title
Secretary
Phone
(904) 605-4986

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

4535 N Beacon St
Chicago, IL 60640-5518

Mailing address

4535 N Beacon St
Chicago, IL 60640-5518
Phone (773) 629-0716

Other identifiers 1

IdentifierTypeStateIssuer
1700042454OtherILNPI 1700042454

National Provider Directory

National Provider Directory

Locations

4753 N Broadway St
Ste 925
Chicago, IL 60640
Phone (773) 989-2780

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1313107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687132800000",
    "number": "1730468307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 N BEACON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405518",
            "telephone_number": "773-629-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 N BEACON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405518",
            "telephone_number": "773-629-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRY SPECIALISTS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-12",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "CLOYD",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "904-605-4986"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 1700042454",
            "identifier": "1700042454",
            "state": "IL"
        }
    ],
    "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 Jun 19, 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.