NPIMap

Organization Active NPI

Pilsen Psychiatric Clinic & Associates, LLC

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1851645964
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PILSEN PSYCHIATRIC CLINIC & ASSOCIATES, LLC
Practice address
1870 S Blue Island Ave
Chicago, IL 60608-3013
Phone
(312) 738-3355
NPI assigned
Oct 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Authorized official

Name
Dr. Krish Venoo, MD
Title
Owner
Phone
(312) 738-3355

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X

Addresses

Primary practice location

1870 S Blue Island Ave
Chicago, IL 60608-3013

Mailing address

1870 S Blue Island Ave
Chicago, IL 60608-3013
Phone (312) 738-3355

National Provider Directory

National Provider Directory

Locations

1870 S Blue Island Ave
Fl 1
Chicago, IL 60608
Phone (312) 564-5246

3350 S Kedzie Ave
Chicago, IL 60623
Phone (312) 564-5246

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": "1351468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354147200000",
    "number": "1851645964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 S BLUE ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606083013",
            "telephone_number": "312-738-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 S BLUE ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606083013",
            "telephone_number": "312-738-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PILSEN PSYCHIATRIC CLINIC & ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-29",
        "last_updated": "2012-11-29",
        "status": "A",
        "authorized_official_last_name": "VENOO",
        "authorized_official_first_name": "KRISH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-738-3355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Nov 29, 2012; 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.