MARYVILLE ACADEMY (NPI# 1487189445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487189445 |
| Entity Type | Organization |
| Organization Name | MARYVILLE ACADEMY |
| Other Organization Name | FAMILY BEHAVIORAL HEALTH CLINIC |
| Practice Address |
951 W Bartlett Rd Bartlett IL 60103-4479 |
| Practice Telephone | 6304834560 |
| Mailing Telephone | 6304834560 |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2017-04-27 |
| Authorized Official Name | SR. CATHERINE RYAN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8472941893 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Family Behavioral Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366957292 | Maryville Academy | Clinic/Center | 1510 N Claremont Ave, Chicago, IL 60622-1710 | 2017-12-14 |
| 1487072781 | Maryville Academy | Clinic/Center | 1455 E Golf Rd Ste 210, Des Plaines, IL 60016-1254 | 2014-04-03 |
| 1508174749 | Maryville Academy | Community Based Residential Treatment Facility, Mental Illness | 1658 W Grand Ave, Chicago, IL 60622-6309 | 2010-09-22 |
| 1275771214 | Maryville Academy | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 951 W Bartlett Rd, Bartlett, IL 60103-4479 | 2009-01-29 |
| 1477700474 | Maryville Academy | Residential Treatment Facility, Emotionally Disturbed Children | 10102 Farm School Rd, Durand, IL 61024-9725 | 2008-08-20 |
| 1578720041 | Maryville Academy | Long Term Care Hospital | 4015 N Oak Park Ave Bldg B, Chicago, IL 60634-7197 | 2008-05-21 |
| 1578697835 | Maryville Academy | Community/Behavioral Health | 1150 N River Rd, Des Plaines, IL 60016-1214 | 2007-03-16 |
| 1306873419 | Maryville Academy | Psychiatric Residential Treatment Facility | 555 Wilson Lane, Maryville Scott Nolan Center, Des Plaines, IL 60016-4729 | 2006-06-26 |
| 1821504788 | Maryville Academy | Clinic/Center | 1510 N Claremont Ave, Chicago, IL 60622-1710 | 2017-12-14 |
| 1003341058 | Maryville Academy | Clinic/Center | 1658 W Grand Ave, Chicago, IL 60622-6309 | 2017-04-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MARYVILLE ACADEMY | 1150 N River Rd, Des Plaines, IL 60016-1214 |
| Street Address |
951 W BARTLETT RD |
| City | BARTLETT |
| State | IL |
| Zip Code | 60103-4479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275771214 | Maryville Academy | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 951 W Bartlett Rd, Bartlett, IL 60103-4479 | 2009-01-29 |
| 1982154480 | Maryville Academy | Clinic/Center | 951 W Bartlett Rd, Bartlett, IL 60103-4479 | 2016-10-07 |
| 1770892028 | Maryville Academy | Community Based Residential Treatment Facility, Mental Illness | 951 W Bartlett Rd, Bartlett, IL 60103-4479 | 2010-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467916593 | Nicole Taylor Gerdevich | Specialist/Technologist | 1302 Branden Lane, Bartlett, IL 60103 | 2019-01-23 |
| 1154817823 | Ada Oguejiofor | Registered Nurse | 269 Norway Drive, Bartlett, IL 60103 | 2018-07-06 |
| 1295153765 | Paul Alegro | Physical Therapy Assistant | 810 Seacrest Lane, Bartlett, IL 60103 | 2014-04-02 |
| 1184051211 | John Katsis | Dentist | 110 S. Oak Avenue, Bartlett, IL 60103 | 2013-10-03 |
| 1356786743 | Rajiv Puri PC | Dentist | 849 S Route 59, Bartlett, IL 60103 | 2013-04-30 |
| 1356786784 | Gilbert Noble Bael | Physical Therapist | 829 Carillon Drive, Bartlett, IL 60103 | 2013-04-29 |
| 1912282641 | Elaine S Tate | Pharmacist | 891 S. Route 59, Bartlett, IL 60103 | 2011-10-13 |
| 1104108968 | Sonal Vyas | Pharmacist | 891 S. Route 59, Bartlett, IL 60103 | 2011-09-16 |
| 1144502261 | Les Edward Wingert | Pharmacist | 891 South Route 59, Bartlett, IL 60103 | 2011-09-14 |
| 1629389564 | Hope Hebert | Counselor | 364 Sundance Drive, Bartlett, IL 60103 | 2010-06-25 |
| Find all providers in zip 60103 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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|---|---|---|---|---|
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| 1457964934 | Rosecrance Inc | Clinic/Center | 15 N Galena Ave, Freeport, IL 61032-4348 | 2020-08-25 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1174148167 | Associates In Behavioral Health Care | Clinic/Center | 910 Lake St Ste 102, Roselle, IL 60172-3384 | 2020-06-15 |
| 1538784533 | Associates In Behavioral Health Care | Clinic/Center | 1375 E Schaumburg Rd Ste 120, Schaumburg, IL 60194-3643 | 2020-06-15 |
| 1265056964 | Gateway Foundation, Inc. | Clinic/Center | 3040 Finley Rd, Downers Grove, IL 60515-5713 | 2020-05-29 |
| 1922634021 | Lutheran Social Services of Illinois | Clinic/Center | 400 N Cherry St, Morrison, IL 61270-2605 | 2020-03-20 |
| 1144852260 | Vincent Wallace | Clinic/Center | 226 W Ontario St, Chicago, IL 60654-3619 | 2020-02-06 |
| 1093354037 | A Bridge Back, Inc. | Clinic/Center | 314 Mchenry Rd, Buffalo Grove, IL 60089-2428 | 2019-12-21 |
| Find all providers with the same taxonomy | ||||
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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.