ELEMENTAL TREATMENT CENTER LTD NPI 1598278749

NPI Information

NPI: 1598278749
Provider Name: ELEMENTAL TREATMENT CENTER LTD
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
612 S WESTERN AVE APT 1
CHICAGO, IL
ZIP 60612
Phone: (331) 330-9955
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ELEMENTAL TREATMENT CENTER LTD is a federally qualified health center (fqhc) clinic center in Chicago, IL. ELEMENTAL TREATMENT CENTER LTD NPI is 1598278749. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

612 S WESTERN AVE APT 1
CHICAGO, IL
ZIP 60612-682
Phone: (331) 330-9955

The provider's authorized official is Martins A Adeoye .
The authorized official title is Ceo and has the following contact phone number (331) 330-9955.

The enumeration date for this NPI number is 11/9/2017 and was last updated on 5/1/2020.

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	Primary
1	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
3	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	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: 11/14/2023

NPI Synchronization or Removal

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