NPIMap

Organization Active NPI

Alexian Brothers Center for Mental Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Arlington Heights, IL
National Provider Identifier
1891486742
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
ALEXIAN BROTHERS CENTER FOR MENTAL HEALTH
Practice address
3436 N Kennicott Ave
Arlington Heights, IL 60004-7814
Phone
(847) 952-7460
NPI assigned
May 19, 2023
Organization subpart
Yes
Parent organization
ALEXIAN BROTHERS CENTER FOR MENTAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Authorized official

Name
Mary Jo Mackniskas
Title
Sr. Director Net Revenue and Reimb
Phone
(773) 213-0776

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X

Addresses

Primary practice location

3436 N Kennicott Ave
Arlington Heights, IL 60004-7814

Mailing address

3436 N Kennicott Ave
Arlington Heights, IL 60004-7814
Phone (847) 952-7460

National Provider Directory

National Provider Directory
Tax ID family
Northwest Mental HLTH C21 organizations share this tax ID, including this one
Part of
Northwest Mental HLTH C

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Practitioners & affiliated clinicians

Practitioners 2

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": "1684454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1891486742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3436 N KENNICOTT AVE",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600047814",
            "telephone_number": "847-952-7460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3436 N KENNICOTT AVE",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600047814",
            "telephone_number": "847-952-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXIAN BROTHERS CENTER FOR MENTAL HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALEXIAN BROTHERS CENTER FOR MENTAL HEALTH",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "MACKNISKAS",
        "authorized_official_first_name": "MARY JO",
        "authorized_official_title_or_position": "SR. DIRECTOR NET REVENUE AND REIMB",
        "authorized_official_telephone_number": "773-213-0776"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.