NPIMap

Organization Active NPI

Maryville Academy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Des Plaines, IL
National Provider Identifier
1962711218
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MARYVILLE ACADEMY
Practice address
1150 N River Rd
Des Plaines, IL 60016-1214
Phone
(847) 294-1999
Fax
(847) 294-2892
NPI assigned
Oct 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Authorized official

Name
Nancy Z Woulfe
Title
Director of Business Development
Phone
(847) 294-1910

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X IL

Addresses

Primary practice location

1150 N River Rd
Des Plaines, IL 60016-1214

Mailing address

1150 N River Rd
Des Plaines, IL 60016-1214
Phone (847) 294-1999

Other names 1

  • St. George Other name

National Provider Directory

National Provider Directory
Tax ID family
Maryville Academy28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657238400000",
    "number": "1962711218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N RIVER RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161214",
            "telephone_number": "847-294-1999",
            "fax_number": "847-294-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N RIVER RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161214",
            "telephone_number": "847-294-1999",
            "fax_number": "847-294-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYVILLE ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A",
        "authorized_official_last_name": "WOULFE",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "847-294-1910"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. George",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "St. George",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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.