CHICAGO NERD THERAPY PLLC NPI 1164003190

NPI Information

  • NPI: 1164003190
  • Provider Name: CHICAGO NERD THERAPY, PLLC
  • Classification: Clinic/Center - 261QM0850X
  • Specialization: Adult Mental Health
  • Entity Type: Organization
  • Other Name: CHICAGO NERD THERAPY, PLLC
  • Address: 5230 N MOBILE AVE
    CHICAGO, IL
    ZIP 60630
  • Phone: (312) 270-0098

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NPI Details

CHICAGO NERD THERAPY, PLLC is an adult mental health clinic center in Chicago, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. CHICAGO NERD THERAPY, PLLC NPI is 1164003190. The provider is registered as an organization entity type.
The provider Other Name Is Chicago Nerd Therapy, Pllc.

The provider's business location address is:

5230 N MOBILE AVE
CHICAGO, IL
ZIP 60630-010
Phone: (312) 270-0098

The provider's authorized official is Eric Koll .
The authorized official title is Clinical Social Worker and has the following contact phone number (312) 270-0098.

The enumeration date for this NPI number is 4/20/2021 and was last updated on 9/20/2023.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0850XClinic/CenterAdult Mental HealthYes

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: 11/21/2025

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