Pride Roc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PRIDE ROC

Practice address

765 W 69TH St
Chicago, IL 60621-2435

Phone

(312) 860-9552

NPI assigned

Jan 12, 2021

Organization subpart

No

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

Authorized official

Name

Benjamin Durchslag

Title

Lead Clinician

Phone

(312) 860-9552

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1922697143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15232",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606155141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 W 69TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606212435",
            "telephone_number": "312-860-9552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDE ROC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2020-12-21",
        "status": "A",
        "authorized_official_last_name": "DURCHSLAG",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "LEAD CLINICIAN",
        "authorized_official_telephone_number": "312-860-9552"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shmuel Price, DO
• Tianna Latrice Price, RN
• Vanessa Price, RN
• Michelle Prickett, M.D.
• Valentina Prida, MA
• Ceymone Pride, PA-C
• Rebecca C Pride, N.P.
• Keith Pridgeon
• Ara Karekin Pridjian, MD
• Vicki Pridjian, APRN, CNP

• Community/Behavioral Health Agency in Chicago, IL
• Providers in Chicago, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.