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AUTUMN HEALTHCARE OF ILLINOIS NPI 1679628705


NPI Information

NPI: 1679628705
Provider Name: AUTUMN HEALTHCARE OF ILLINOIS
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
4505 S DREXEL BLVD
CHICAGO, IL
ZIP 60653
Phone: (773) 285-0550
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AUTUMN HEALTHCARE OF ILLINOIS is a mental health counselor in Chicago, IL. AUTUMN HEALTHCARE OF ILLINOIS NPI is 1679628705. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4505 S DREXEL BLVD
CHICAGO, IL
ZIP 60653-301
Phone: (773) 285-0550

The provider's authorized official is Pamela Ann Brazelton-sykes .
The authorized official title is Executive Director and has the following contact phone number (773) 420-3481.

The enumeration date for this NPI number is 1/25/2007 and was last updated on 1/31/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YM0800XCounselorMental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11487709697OTHERILLINOISNPI
2207655OTHERILLINOISNO TITLE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.