NPIMap

Organization Active NPI

Illinois Department of Human Services

Doing business as John J Madden Mental Health

  • Psychiatric Hospital
  • Hines, IL
National Provider Identifier
1902903487
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Doing business as
John J Madden Mental Health
Practice address
1200 South First Ave
Hines, IL 60141-7000
Phone
(708) 338-7048
Fax
(708) 338-7233
NPI assigned
Sep 19, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X IL Primary

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 1

  • John J Madden Mental Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

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

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1902903487. Details of each certification follow.

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
GovernmentNon-profit
Enrollment address
1200 S 1St Ave
Hines, IL 60141-0800
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Hospital certification: CCN 144020

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
JOHN J MADDEN MENTAL HLTH CTR
Certification status
Terminated Involuntary: failure to meet health/safety requirements, Jan 4, 1988
Provider type (POS)
Hospital – Psychiatric
Participating since
Mar 1, 1972
Last certification
Oct 7, 1987
Beds
224
Ownership / control type
State
Facility address
1200 S 1St Ave
Hines, IL 60141

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 16

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

View all 16

Care Compare: Hospital

Medicare Care Compare
Listed as
Madden Mental Health CenterCCN 144028 · All quality measures
Type
Psychiatric
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Howe Center - Unit 4269292 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

4500 College Ave
Alton, IL 62002
Phone (618) 474-3227

7600 183rd St
Tinley Park, IL 60477
Phone (708) 614-3585

Ownership & related parties

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 OfficerBureau Chief Jul 1, 2016
Mark a Bartolozzi Individual Corporate Director Jul 16, 2016
W-2 Managing EmployeeDirector of Fiscal Services Jul 16, 2016
Illinois Department of Human Services Organization, Springfield, IL 5% Or Greater Direct Ownership Interest Jul 1, 1975 100%

Owners & managing parties with NPI records 6

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

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 CenterElgin, IL, CCN 144037 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1975
Chicago Read Mental Health CenterChicago, IL, CCN 144010 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1970
Elizabeth Parsons Ware Packard Mental Health CenterSpringfield, IL, CCN 144021 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1975
Alton Mental Health CenterAlton, IL, CCN 144016 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 1, 1996

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 49

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 49

NPI Registry JSON

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1902903487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SOUTH FIRST AVE",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601417000",
            "telephone_number": "708-338-7048",
            "fax_number": "708-338-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SOUTH FIRST AVE",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601417000",
            "telephone_number": "708-338-7048",
            "fax_number": "708-338-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS DEPARTMENT OF HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "708-338-7257"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John J Madden Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hines, IL

Sources for this page

Verify at the official NPI Registry.