MC DERMOTT CENTER (NPI# 1376080572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376080572 |
| Entity Type | Organization |
| Organization Name | MC DERMOTT CENTER |
| Other Organization Name | HAYMARKET CENTER |
| Practice Address |
108 N Sangamon St Chicago IL 60607-2202 |
| Mailing Address |
932 W Washington Blvd Chicago IL 60607-2217 |
| Practice Telephone | 3122267984 |
| Practice Fax Number | 3122268048 |
| Mailing Telephone | 3122267984 |
| Mailing Fax Number | 3122268048 |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2019-07-10 |
| Authorized Official Name | DR. DAN LUSTIG (PRESIDENT/CEO) |
| Authorized Official Telephone | 3122267984 |
| Authorized Official Credential | PSY. D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 17001 | IL | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Haymarket Center | Doing Business As Name - Organization |
| Street Address |
108 N SANGAMON ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60607-2202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346628591 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 108 N Sangamon St, 5th Floor, Chicago, IL 60607-2202 | 2015-05-08 |
| 1265810832 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 108 N Sangamon St, 3rd Floor, Chicago, IL 60607-2202 | 2015-05-14 |
| 1366820920 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 108 N Sangamon St, 5th Floor, Chicago, IL 60607-2202 | 2015-05-14 |
| 1023496221 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 108 N Sangamon St, 4th Floor, Chicago, IL 60607-2202 | 2015-05-08 |
| 1588042782 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 108 N Sangamon St, 3rd Floor, Rm 319-329, Chicago, IL 60607-2202 | 2015-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992349237 | Portia Dowd | Registered Nurse | 140 N Ashland, Chicago, IL 60607 | 2019-10-30 |
| 1114577210 | Joseph Matthew Thiel | Emergency Medical Technician, Intermediate | 558 West De Koven, Chicago, IL 60607 | 2019-09-19 |
| 1215585757 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 1034 West Lake St, Chicago, IL 60607 | 2019-08-28 |
| 1003462821 | Michael Marek Maka | Psychologist | 820 W. Jackson Blvd, Suite 515, Chicago, IL 60607 | 2019-08-16 |
| 1558922344 | Kellie Meyer | Speech-Language Pathologist | Eyas Landing West Loop, 1409 W. Carroll Ave, Chicago, IL 60607 | 2019-06-24 |
| 1811460108 | Corinna House | Social Worker | 932 W Washington, Chicago, IL 60607 | 2019-01-09 |
| 1962979518 | Louise Taussig Bush | Counselor | 1142 West Madison Street, Suite 406, Chicago, IL 60607 | 2018-10-31 |
| 1568941318 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1051 W Randolph, Chicago, IL 60607 | 2018-08-13 |
| 1851883425 | Alefiyah Zulfiqar Pishori | Psychologist | 1200 West Harrison St, Chicago, IL 60607 | 2018-05-30 |
| 1679062954 | Elizabeth R Rolston | Physical Therapist | 24 S Morgan St Ste 100, Chicago, IL 60607 | 2018-05-02 |
| Find all providers in zip 60607 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245851690 | Brown Health Care Solutions LLC | Community Based Residential Treatment Facility, Mental Illness | 7330 S Blackstone Ave, Chicago, IL 60619-2150 | 2020-04-27 |
| 1376187617 | Haven Pointe L3c | Community Based Residential Treatment Facility, Mental Illness | 4056 W 115th St Apt 100, Chicago, IL 60655-4333 | 2019-10-30 |
| 1093209264 | Lester & Rosalie Anixter Center | Community Based Residential Treatment Facility, Mental Illness | 5108 W Roscoe St, Chicago, IL 60641-4204 | 2018-06-20 |
| 1376839274 | Community Mental Health Council, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2443 E 77th St, Chicago, IL 60649-4730 | 2011-06-20 |
| 1821384736 | Community Mental Health Council, Inc. | Community Based Residential Treatment Facility, Mental Illness | 7919 S Essex Ave, Chicago, IL 60617-1213 | 2011-06-20 |
| 1669768560 | Community Mental Health Council, Inc. | Community Based Residential Treatment Facility, Mental Illness | 8006 S Essex Ave, Chicago, IL 60617-1221 | 2011-06-20 |
| 1427344332 | Community Mental Health Council, Inc | Community Based Residential Treatment Facility, Mental Illness | 7131 S Western Ave, Chicago, IL 60636-3614 | 2011-06-20 |
| 1831485739 | Community Mental Health Council, Inc | Community Based Residential Treatment Facility, Mental Illness | 7133 S Western Ave, Chicago, IL 60636-3614 | 2011-06-20 |
| 1639465545 | Community Mental Health Council, Inc | Community Based Residential Treatment Facility, Mental Illness | 7701 S Phillips Ave, Chicago, IL 60649-4705 | 2011-06-20 |
| 1265727614 | Community Mental Health Council, Inc | Community Based Residential Treatment Facility, Mental Illness | 7623 S Essex Ave, Chicago, IL 60649-4037 | 2011-06-14 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.