Active NPI
Chicago Neurobehavior Specialists
- Clinical Psychologist
- Orland Park, IL
National Provider Identifier
1780936856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- CHICAGO NEUROBEHAVIOR SPECIALISTS
- Practice address
- 15040 S Ravinia Ave Ste 49
Orland Park, IL 60462-3173 - Phone
- (708) 349-4420
- Fax
- (708) 349-4421
- NPI assigned
- Oct 12, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Heather Castillo
- Title
- Practice Manager
- Phone
- (708) 349-4420
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | Primary |
Addresses
Primary practice location
15040 S Ravinia Ave Ste 49
Orland Park, IL 60462-3173
Mailing address
15040 S Ravinia Ave Ste 49
Orland Park, IL 60462-3173
Phone (708) 349-4420
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130805000980 | IL | Part B Supplier - Clinic/Group Practice | 1658513544 |
Receives reassigned benefits from 4 practitioners Practice locations: Orland Park, IL |
National Provider Directory
National Provider DirectoryLocations
15010 S Ravinia Ave
Ste 14
Orland Park, IL 60462
Phone (708) 349-4420
Practitioners & affiliated clinicians
Practitioners 4
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": "1350000000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1654819200000",
"number": "1780936856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15040 S RAVINIA AVE STE 49",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604623173",
"telephone_number": "708-349-4420",
"fax_number": "708-349-4421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15040 S RAVINIA AVE STE 49",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604623173",
"telephone_number": "708-349-4420",
"fax_number": "708-349-4421"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHICAGO NEUROBEHAVIOR SPECIALISTS",
"organizational_subpart": "NO",
"enumeration_date": "2012-10-12",
"last_updated": "2022-06-10",
"certification_date": "2022-06-10",
"status": "A",
"authorized_official_last_name": "CASTILLO",
"authorized_official_first_name": "HEATHER",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "708-349-4420"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orland Park, IL
- Samantha Chiariello, PSYD
- Chicago Anti-Aging Institution 2
- Chicago Christian Counseling Center Inc
- Chicago Hearing LLC
- Chicago Medical Group, Inc.
- Chicago Oral Medicine
- Chicago Rehabilitation Consultants LLC
- Chicago Spine and Joint, S.C.
- Chicagoland Foot and Ankle PC
- Jennifer Elizabeth Chicoine, M.A., LCPC, CCTP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.