MCDERMOTT CENTER (NPI# 1619355542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619355542 |
| Entity Type | Organization |
| Organization Name | MCDERMOTT CENTER |
| Other Organization Name | HAYMARKET CENTER |
| Practice Address |
4753 N Broadway St Suite 612 Chicago IL 60640-5266 |
| 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 | 2015-05-12 |
| Last Update Date | 2015-05-12 |
| Authorized Official Name | MR. RAYMOND F SOUCEK (PRESIDENT & CEO) |
| Authorized Official Telephone | 3122267984 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | A-0349-0037 | IL | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Haymarket Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861870503 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 10000 West Ohare Avenue, O'hare International Airport, Chicago, IL 60666 | 2015-05-14 |
| 1346628591 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 108 N Sangamon St, 5th Floor, Chicago, IL 60607-2202 | 2015-05-08 |
| 1356729479 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 124 N Sangamon St, 6th Floor, Chicago, IL 60607-2202 | 2015-05-08 |
| 1780061259 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 215 W Water St, Waukegan, IL 60085-5616 | 2015-05-04 |
| 1902283641 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 932 W Washington Blvd, 6th Floor, Room 604-611, Chicago, IL 60607-2217 | 2015-05-01 |
| 1518034693 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 120 N Sangamon St, Chicago, IL 60607-2202 | 2006-11-30 |
| 1265807390 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 120 N Sangamon St, 4th Floor, Chicago, IL 60607-2202 | 2015-12-01 |
| 1720466386 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 124 N Sangamon St, 1,2,3,4,5th Floor, Chicago, IL 60607-2202 | 2015-05-14 |
| 1265810832 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 108 N Sangamon St, 3rd Floor, Chicago, IL 60607-2202 | 2015-05-14 |
| 1447638002 | Mcdermott Center | Substance Abuse Rehabilitation Facility | 932 W Washington Blvd, 3rd Floor, Rooms 303,304,305,307, Chicago, IL 60607-2217 | 2015-05-14 |
| Street Address |
4753 N BROADWAY ST SUITE 612 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60640-5266 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578560736 | Roberta Sue Barry | Social Worker | 4753 N Broadway St, Suite 928, Chicago, IL 60640-5266 | 2005-07-02 |
| 1538667084 | Kenan Pojskic | Clinic/Center | 4753 N Broadway St, Chicago, IL 60640-5266 | 2018-01-30 |
| 1033617865 | Kamran Naseem Malik | Clinic/Center | 4753 N Broadway St, Chicago, IL 60640-5266 | 2018-01-26 |
| 1912405895 | Hrishikesh T Shetty | Clinic/Center | 4753 N Broadway St, Chicago, IL 60640-5266 | 2018-01-25 |
| 1639614209 | Joanne Kardell | Social Worker | 4753 N Broadway St, 826, Chicago, IL 60640-5266 | 2017-01-05 |
| 1376997379 | Sachiko Kawata | Social Worker | 4753 N Broadway St, Suite #925, Chicago, IL 60640-5266 | 2016-04-16 |
| 1619321692 | Jennifer Annen | Counselor | 4753 N Broadway St, Suite 826, Chicago, IL 60640-5266 | 2016-04-15 |
| 1225434236 | Joanna Vergoth | Social Worker | 4753 N Broadway St, Suite 509, Chicago, IL 60640-5266 | 2014-11-18 |
| 1548662257 | Daniel N Danforth | Acupuncturist | 4753 N Broadway St, Ste 810, Chicago, IL 60640-5266 | 2014-09-24 |
| 1245668979 | Joanne Marwil, Psy.d. and Associates | Psychologist | 4753 N Broadway St, Suite 826, Chicago, IL 60640-5266 | 2013-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
| 1548871916 | Borici Counseling LLC | Counselor | 4731 N Paulina St, Chicago, IL 60640 | 2020-08-11 |
| 1306319173 | Gerardo Garcia | Physician Assistant | Medical Staff Office, Weiss Memorial Hospital, 4646 N Marine Drive, Chicago, IL 60640 | 2019-01-04 |
| 1386121283 | Aea Optical Ventures, LLC | Clinic/Center | 4814 N Clark St, Chicago, IL 60640 | 2018-07-24 |
| 1023503885 | Lauren Vassiliades | Internal Medicine | Weiss Memorial Hospital, Medical Education Dpt., 4646 N. Marine Drive, C Elevators, 7th Flr. # 7100, Chicago, IL 60640 | 2018-06-25 |
| 1477061620 | Yesenia Vargas | Nurse Practitioner | 1025 W Sunnyside, Chicago, IL 60640 | 2018-01-22 |
| 1932622206 | Jasleen Kaur Brar | Internal Medicine | 4646 N. Marine Dr., Chicago, IL 60640 | 2017-07-19 |
| 1750802849 | Umer Mukhtar | Internal Medicine | 4646 N. Marine Dr. Med Ed Dept. C Elevators., Weiss Memorial Hospital. 7 Floor. #7100, Chicago, IL 60640 | 2017-06-29 |
| 1184144081 | Ellie Navidson | Registered Nurse | 1015 W Lawrence, 2nd Floor, Chicago, IL 60640 | 2017-06-21 |
| 1962932558 | Jennifer Stridh | Marriage & Family Therapist | 5125 N. Winthrop Ave, 1f, Chicago, IL 60640 | 2017-06-15 |
| Find all providers in zip 60640 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063989143 | Northwest Recovery Center LLC | Substance Abuse Rehabilitation Facility | 5352 N Lincoln Ave Ste 250, Chicago, IL 60625-2316 | 2018-10-26 |
| 1982182671 | Rosecrance, Inc. | Substance Abuse Rehabilitation Facility | 2835 N Sheffield Ave Ste 209, Chicago, IL 60657-5083 | 2018-08-03 |
| 1619453610 | Head Heart Therapy | Substance Abuse Rehabilitation Facility | 4809 N Ravenswood Ave Unit 227, Chicago, IL 60640-4417 | 2018-07-13 |
| 1891296802 | The Ids Group Chicago | Substance Abuse Rehabilitation Facility | 1117 N Ashland Ave, Chicago, IL 60622-3986 | 2018-02-25 |
| 1548774961 | Prentice Place | Substance Abuse Rehabilitation Facility | 255 W 112th Pl, Chicago, IL 60628-4132 | 2017-11-21 |
| 1821537739 | Cornerstone Recovering Community | Substance Abuse Rehabilitation Facility | 28 W 113th Pl, Chicago, IL 60628-4811 | 2017-02-13 |
| 1538608443 | Cornerstone Recovering Community | Substance Abuse Rehabilitation Facility | 44 W 112th Pl, Chicago, IL 60628-4806 | 2017-02-13 |
| 1093254906 | Cornerstone Recovering Community | Substance Abuse Rehabilitation Facility | 139 W 112th St, Chicago, IL 60628-4803 | 2017-02-13 |
| 1083152359 | Cornerstone Recovering Community | Substance Abuse Rehabilitation Facility | 103 W 112th St, Chicago, IL 60628-4803 | 2017-02-07 |
| 1336529858 | Rosecrance Inc | Substance Abuse Rehabilitation Facility | 1556 W. Waveland Avenue, Chicago, IL 60613-3601 | 2015-06-01 |
| 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.