NPIMap

Organization Active NPI

Alexian Brothers Behavioral Health Hospital

Doing business as Alexian Brothers Behavioral Health Hospital Outpatient Group Practice

  • Psychiatry Physician
  • Hoffman Estates, IL
National Provider Identifier
1801318928
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL
Doing business as
Alexian Brothers Behavioral Health Hospital Outpatient Group Practice
Practice address
1786 Moon Lake Blvd Ste 104
Hoffman Estates, IL 60169-1016
Phone
(847) 755-8090
Fax
(847) 843-7393
NPI assigned
Jul 11, 2017
Last updated
May 30, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Clayton Ciha
Title
Ceo
Phone
(847) 755-8001

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A0401X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X
Geriatric Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0805X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SP0807X
Adult Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SP0809X
Geropsychiatric Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SP0813X

Addresses

Primary practice location

1786 Moon Lake Blvd Ste 104
Hoffman Estates, IL 60169-1016

Mailing address

1786 Moon Lake Blvd Ste 104
Hoffman Estates, IL 60169-1016
Phone (847) 755-8090

Other names 1

  • Alexian Brothers Behavioral Health Hospital Outpatient Group Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040908000182 IL Part B Supplier - Clinic/Group Practice 9537062138 Receives reassigned benefits from 65 practitioners
1 other NPI on this enrollment
Practice locations: Chicago, IL; Bartlett, IL; Westmont, IL; South Barrington, IL; Schaumburg, IL; Lake Zurich, IL; Hoffman Estates, IL; Crystal Lake, IL

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2141833Alexian Brothers Outpatient Group Practice1786 Moon Lake Blvd - Ste 104, Hoffman Estates, IL 60169Certificate of waiverDec 21, 2027

National Provider Directory

National Provider Directory
Part of
Alexian Bro Behavioral Hosp

Locations

21272 Network Pl
Chicago, IL 60673

500 Coventry Ln
Ste 250
Crystal Lake, IL 60014
Phone (224) 273-9990

750 W Elk Grove Blvd
Elk Grove Village, IL 60007

800 Biesterfield Rd
Ste 655
Elk Grove Village, IL 60007

810 Biesterfield Rd
Ste 403
Elk Grove Vlg, IL 60007
Phone (847) 593-6363

1786 Moon Lake Blvd
Ste 202
Hoffman Estates, IL 60169
Phone (847) 230-3526

2500 W Higgins Rd
Ste 440
Hoffman Estates, IL 60169
Phone (847) 839-0400

2515 Palatine Rd
Inverness, IL 60067
Phone (847) 514-3835

1451 Bode Rd
Schaumburg, IL 60194

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 100

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 100

NPI Registry JSON

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1801318928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 MOON LAKE BLVD STE 104",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691016",
            "telephone_number": "847-755-8090",
            "fax_number": "847-843-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1786 MOON LAKE BLVD STE 104",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691016",
            "telephone_number": "847-755-8090",
            "fax_number": "847-843-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL",
        "enumeration_date": "2017-07-11",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "CIHA",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-755-8001"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0807X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0813X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Geropsychiatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alexian Brothers Behavioral Health Hospital Outpatient Group Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alexian Brothers Behavioral Health Hospital Outpatient Group Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hoffman Estates, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.