NPIMap

Organization Active NPI

Pilsen Little Village Community Mental Health Center

Doing business as Pilsen Wellness Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cicero, IL
National Provider Identifier
1962712406
Registry record updated Apr 9, 2021
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
PILSEN LITTLE VILLAGE COMMUNITY MENTAL HEALTH CENTER
Doing business as
Pilsen Wellness Center, Inc
Practice address
1407 S 49TH CT
Cicero, IL 60804-1428
Phone
(708) 683-5500
Fax
(708) 683-5505
NPI assigned
Oct 18, 2010
Last updated
Apr 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Authorized official

Name
Dr. Francisco Cisneros
Title
President/Ceo
Phone
(773) 579-0832

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1407 S 49TH CT
Cicero, IL 60804-1428

Mailing address

2319 S Damen Ave
Chicago, IL 60608-4209
Phone (773) 579-0832

Other names 1

  • Pilsen Wellness Center, Inc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pilsen Wellness Center Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations

1407 S 49th Ct
Cicero, IL 60804
Phone (708) 683-5500

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1962712406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2319 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084209",
            "telephone_number": "773-579-0832",
            "fax_number": "773-579-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 S 49TH CT",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608041428",
            "telephone_number": "708-683-5500",
            "fax_number": "708-683-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PILSEN LITTLE VILLAGE COMMUNITY MENTAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "CISNEROS",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "773-579-0832",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pilsen Wellness Center, Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pilsen Wellness Center, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cicero, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.