MARYVILLE ACADEMY NPI 1902353782

NPI Information

  • NPI: 1902353782
  • Provider Name: MARYVILLE ACADEMY
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Doing Business As: FAMILY BEHAVIORAL HEALTH CLINIC
  • Address: 1658 W GRAND AVE
    CHICAGO, IL
    ZIP 60622
  • Phone: (312) 491-3530

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NPI Details

MARYVILLE ACADEMY is a mental health (including community mental health center) clinic center in Chicago, IL. MARYVILLE ACADEMY NPI is 1902353782. The provider is registered as an organization entity type.
The provider Is Doing Business As Family Behavioral Health Clinic.

The provider's business location address is:

1658 W GRAND AVE
CHICAGO, IL
ZIP 60622-309
Phone: (312) 491-3530

The provider's authorized official is Nancy Z Woulfe .
The authorized official title is Director Of Business Development and has the following contact phone number (847) 294-1910.

The enumeration date for this NPI number is 9/8/2016 and was last updated on 7/11/2022.

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
1261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
2261QM0850XClinic/CenterAdult Mental HealthNo
3261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)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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