SURVIVORS CIRCLE NPI 1437916962

NPI Information

  • NPI: 1437916962
  • Provider Name: SURVIVORS CIRCLE
  • Classification: Clinic/Center - 261QP0905X
  • Specialization: Public Health, State or Local
  • Entity Type: Organization
  • Other Name: PHYLLA HOUSE CLINIC
  • Address: 1332 GREENFIELD AVE
    WAUKEGAN, IL
    ZIP 60085
  • Phone: (708) 548-9209

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NPI Details

SURVIVORS CIRCLE is a public health and state or local clinic center in Waukegan, IL. SURVIVORS CIRCLE NPI is 1437916962. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Phylla House Clinic.

The provider's business location address is:

1332 GREENFIELD AVE
WAUKEGAN, IL
ZIP 60085-813
Phone: (708) 548-9209

The provider's authorized official is Robert H Marshall .
The authorized official title is Ceo and has the following contact phone number (708) 548-9209.

The enumeration date for this NPI number is 3/1/2024 and was last updated on 6/17/2024.

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
1101YM0800XCounselorMental HealthNo
2101YP1600XCounselorPastoralNo
3103TR0400XPsychologistRehabilitationNo
4104100000XSocial WorkerNo
5163WD0400XRegistered NurseDiabetes EducatorNo
6251K00000XPublic Health or WelfareNo
7261QC1500XClinic/CenterCommunity HealthNo
8261QD1600XClinic/CenterDevelopmental DisabilitiesNo
9261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
10261QM0850XClinic/CenterAdult Mental HealthNo
11261QP0905XClinic/CenterPublic Health, State or LocalYes
12261QP2400XClinic/CenterPrison HealthNo
13261QR0800XClinic/CenterRecovery CareNo
14374K00000XReligious Nonmedical PractitionerNo

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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