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Illinois Department of Human Services

Organization Active NPI Psychiatric Hospital · Hines, IL

NPI 1902903487 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1902903487
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric Hospital 283Q00000X
Legal business name
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Practice address
1200 South First Ave
Hines, IL 60141-7000
Phone
(708) 338-7048
Fax
(708) 338-7233
NPI assigned
Sep 19, 2006
Organization subpart
No

Authorized official

Name
Janice Evans
Title
Business Administrator
Phone
(708) 338-7257

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 16

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

Other NPIs with the same Medicare PAC ID 6

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

Corporate family (same tax ID) 24

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

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 49

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 49

Medicare Care Compare: Hospital

Listed as
Madden Mental Health Center CCN 144028
Type
Psychiatric
Ownership
Government - State
Medicare certification status
Active (Provider of Services file)
Emergency services
No

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in IL

Hospital certification: CCN 144028

Legal name
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Doing business as
JOHN J MADDEN MENTAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Nov 17, 1988
Last certification
Aug 19, 2016
Beds
269 (50 certified)
Ownership / control type
State
Organization structure
Government · Non-profit
Enrollment address
1200 S 1St Ave
Hines, IL 60141-0800
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Victoria Pyles
Individual 		Corporate Officer
Bureau Chief		 Jul 1, 2016
Mark a Bartolozzi
Individual 		Corporate Director Jul 16, 2016
W-2 Managing Employee
Director of Fiscal Services		 Jul 16, 2016
Illinois Department of Human Services
Organization · Springfield, IL 		5% Or Greater Direct Ownership Interest Jul 1, 1975 100%

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Elgin Mental Health Center
Elgin, IL · CCN 144037		 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1975
Chicago Read Mental Health Center
Chicago, IL · CCN 144010		 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1970
Elizabeth Parsons Ware Packard Mental Health Center
Springfield, IL · CCN 144021		 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1975
Alton Mental Health Center
Alton, IL · CCN 144016		 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 1, 1996

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031113000414 IL Part B Supplier - Clinic/Group Practice 9830003920 Receives reassigned benefits from 43 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Centralia, IL; Waukegan, IL; Park Forest, IL; Kankakee, IL; Hines, IL; Dwight, IL; Dixon, IL; Chicago, IL…
O20080417000464 IL Part a Provider - Hospital 9830003920 Practice locations: Hines, IL

National Provider Directory

Tax ID family
Howe Center - Unit 4264 (292 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X IL Yes

Addresses

Primary practice location

1200 South First Ave
Hines, IL 60141-7000

Mailing address

1200 South First Ave
Hines, IL 60141-7000
Phone (708) 338-7048

Other names

  • John J Madden Mental Health Doing business as

Other providers in Hines, IL

All providers in Hines, IL · Psychiatric Hospital in Illinois

Sources for this page

Verify at the official NPI Registry.