Alexian Brothers Behavioral Health Hospital
Organization Active NPI Psychiatry Physician · Hoffman Estates, IL
NPI 1801318928 · NPPES record last updated May 30, 2024
Key facts
- NPI
- 1801318928
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL
- 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
- Organization subpart
- Yes
- Parent organization (as reported)
- ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL
Authorized official
- Name
- Clayton Ciha
- Title
- Ceo
- Phone
- (847) 755-8001
Parent organization (reported in NPPES) 1
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Practitioners 100
-
Kamlesh Banker, LCSW
-
Rachael L Benbrook, LCSW
-
Mary Michelle Berkos, LCSW
-
Madelyn M Burbank, LCSW
-
Lisa Chico, LCSW
-
Bradley Thomas Cramer, MSED, LCPC, CCMHC
-
Pamela M Davis, LSCW
-
Damien Dodd, L.C.S.W.
-
Therese Draper, APN
-
Gia Grimmitt, LCPC
-
Michelle Hazenfield, LCSW
-
Michelle Hyman, LCSW
-
Melissa Ivins-Lukse, PHD
-
Amber Kazi, M.D.
-
Krists Klegeris, PMHNP-BC
-
Clarice Marie La France, MS, RN, LCPC, CADC
-
Annette Lacey, PSY.D.
-
Rebecca Lepoff, LCSW
-
Sean S McGrew, LCSW
-
Theresa B Mikosz, LCPC
-
Ericka Marie Ortiz, LCPC
-
Alisa Renee Prantner, APN, PMHNP-CS
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2141833 | Alexian Brothers Outpatient Group Practice | Certificate of waiver | Dec 21, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Part of
- Alexian Brothers Behavioral
Locations
21272 Network Pl
Chicago, IL 60673
500 Coventry Ln
Ste 250
Crystal Lake, IL 60014
Phone (224) 273-9990
495 Alexandra Blvd
Crystal Lake, IL 60014
Phone (815) 356-3064
750 W Elk Grove Blvd
Elk Grove Village, IL 60007
800 Biesterfield Rd
Ste 655
Elk Grove Village, IL 60007
800 Biesterfield Rd
Ste 610
Elk Grove Vlg, IL 60007
Phone (847) 981-3630
2500 W Higgins Rd
Ste 440
Hoffman Estates, IL 60169
Phone (847) 839-0400
1786 Moon Lake Blvd
Ste 202
Hoffman Estates, IL 60169
Phone (847) 252-7577
2515 Palatine Rd
Inverness, IL 60067
Phone (847) 514-3835
235 S Rand Rd
Lake Zurich, IL 60047
Phone (847) 438-3770
50 S Northwest Hwy
Palatine, IL 60074
Phone (847) 202-6020
4225 Kirchoff Rd
Rolling Meadows, IL 60008
Phone (224) 456-6662
1451 Bode Rd
Schaumburg, IL 60194
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Mental Health Counselor |
101YM0800X | |||
| Professional Counselor |
101YP2500X | |||
| Clinical Psychologist |
103TC0700X | |||
| Clinical Child & Adolescent Psychologist |
103TC2200X | |||
| Clinical Social Worker |
1041C0700X | |||
| Addiction Medicine (Psychiatry & Neurology) Physician |
2084A0401X | |||
| Psychiatry Physician |
2084P0800X | Yes | ||
| Child & Adolescent Psychiatry Physician |
2084P0804X | |||
| Geriatric Psychiatry Physician |
2084P0805X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | |||
| Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist |
364SP0807X | |||
| Adult Psychiatric/Mental Health Clinical Nurse Specialist |
364SP0809X | |||
| Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist |
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
- Alexian Brothers Behavioral Health Hospital Outpatient Group Practice
Other providers in Hoffman Estates, IL
- Alden-Poplar Creek Rehabilitation and Health Care Center, Inc.
- Alexander & Associates Women'S Health Care, S.C.
- Gail Alexander
- Taylor Amanda Alexander
- Alexian Brothers Behavioral Health Hospital
- Allen Saxon MD PC
- Almond Homecare LLC
- Dima Alnahas
- Alpha Healthcare Institute, Inc.
- Kelly Altman
All providers in Hoffman Estates, IL · Psychiatry Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.