NPI |
1740462597 |
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified. |
Entity Type Code |
2 |
The name of the organization provider. If the provider is an organization, this is the legal business name. |
Employer Identification Number EIN |
|
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Provider Organization Name Legal Business Name |
PSYCHIATRIC PERSPECTIVES |
The city name in the location address of the provider being identified. |
Provider First Line Business Practice Location Address |
1650 MOON LAKE BLVD |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address City Name |
HOFFMAN ESTATES |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address State Name |
IL |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address Postal Code |
601691010 |
The telephone number associated with the location address of the provider being identified. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The fax number associated with the location
address of the provider being identified. |
Provider Business Practice Location Address Telephone Number |
8477057882 |
The telephone number associated with the location address of the provider being identified. |
Provider Enumeration Date |
12/4/2007 |
The telephone number associated with the location address of the provider being identified. |
Last Update Date |
2/14/2008 |
The telephone number associated with the location address of the provider being identified. |
Authorized Official Last Name |
DELOSSANTOS |
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
Authorized Official First Name |
RENATO |
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
Authorized Official Title or Position |
PRESIDENT |
The title or position of the authorized official. |
Authorized Official Telephone Number |
8477057882 |
The title or position of the authorized official. |
Healthcare Provider Taxonomy Code 1 |
101YM0800X |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Is Organization Subpart |
N |
|
Authorized Official Name Prefix Text |
DR. |
|
Healthcare Provider Taxonomy Group 1 |
193400000X MULTIPLE SINGLE SPECIALTY GROUP |
|