COLUMBUS MANOR NPI 1336608439

NPI Information

  • NPI: 1336608439
  • Provider Name: COLUMBUS MANOR
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Organization
  • Address: 5107 W JACKSON BLVD
    CHICAGO, IL
    ZIP 60644
  • Phone: (708) 862-4054

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NPI Details

COLUMBUS MANOR is an addiction (substance use disorder) counselor in Chicago, IL. COLUMBUS MANOR NPI is 1336608439. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5107 W JACKSON BLVD
CHICAGO, IL
ZIP 60644-316
Phone: (708) 862-4054
Fax: (708) 862-4138

The provider's authorized official is James Edward Beckett .
The authorized official title is Medical Director/president and has the following contact phone number (708) 341-6707.

The enumeration date for this NPI number is 3/18/2019 and was last updated on 3/18/2019.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)Yes

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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