| Alexian Brothers Behavioral Health Hospital Outpatient Group Practice | |
|
1786 Moon Lake Blvd Ste 104 Hoffman Estates IL 60169-1016 | |
| (847) 755-8090 | |
| (847) 843-7393 |
| Full Name | Alexian Brothers Behavioral Health Hospital Outpatient Group Practice |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1786 Moon Lake Blvd Ste 104, Hoffman Estates, Illinois |
| Authorized Official Name and Position | Clayton Ciha (CEO) |
| Authorized Official Contact | 8477558001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alexian Brothers Behavioral Health Hospital Outpatient Group Practice 1786 Moon Lake Blvd Ste 104 Hoffman Estates IL 60169-1016 Ph: (847) 755-8090 | Alexian Brothers Behavioral Health Hospital Outpatient Group Practice 1786 Moon Lake Blvd Ste 104 Hoffman Estates IL 60169-1016 Ph: (847) 755-8090 |
| NPI Number | 1801318928 |
|---|---|
| Provider Enumeration Date | 07/11/2017 |
| Last Update Date | 05/30/2024 |
| Certification Date | 05/30/2024 |
| Medicare PECOS PAC ID | 9537062138 |
|---|---|
| Medicare Enrollment ID | O20040908000182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801318928 | NPI | - | NPPES |
| Provider Name | Michelle K Hyman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679566491 PECOS PAC ID: 1759363765 Enrollment ID: I20040603000690 |
| Provider Name | Christopher A Dagostino |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568494987 PECOS PAC ID: 5799757159 Enrollment ID: I20040806001216 |
| Provider Name | Karen S Dicken |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1063420230 PECOS PAC ID: 8628044096 Enrollment ID: I20040907001248 |
| Provider Name | Kamlesh A Banker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235165903 PECOS PAC ID: 7113980772 Enrollment ID: I20041105000145 |
| Provider Name | Gregory A Teas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386677334 PECOS PAC ID: 6800845348 Enrollment ID: I20050121000478 |
| Provider Name | Michelle Celine Hazenfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730192295 PECOS PAC ID: 4587678297 Enrollment ID: I20060202000198 |
| Provider Name | William H Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588695209 PECOS PAC ID: 1557376514 Enrollment ID: I20060213000193 |
| Provider Name | Pamela M Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528174794 PECOS PAC ID: 8224038385 Enrollment ID: I20070115000011 |
| Provider Name | Patrick B Mcgrath |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972686459 PECOS PAC ID: 7911001235 Enrollment ID: I20070327000164 |
| Provider Name | Salahuddin Irfan Syed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891997870 PECOS PAC ID: 1850491739 Enrollment ID: I20070706000145 |
| Provider Name | Laura C Bauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104877000 PECOS PAC ID: 7911089669 Enrollment ID: I20080202000074 |
| Provider Name | Anthony F Gorrie |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104839646 PECOS PAC ID: 0143377689 Enrollment ID: I20090420000576 |
| Provider Name | Mary E Davitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871722652 PECOS PAC ID: 6800934225 Enrollment ID: I20091105000074 |
| Provider Name | Heather B Waldman Cintron |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619101961 PECOS PAC ID: 8426192006 Enrollment ID: I20100219000704 |
| Provider Name | Michael Brilliant |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588779151 PECOS PAC ID: 1456477454 Enrollment ID: I20100928000399 |
| Provider Name | Anothony M Dagostino |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295762649 PECOS PAC ID: 0547393910 Enrollment ID: I20100928000426 |
| Provider Name | Kumudini H Ginde |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114959517 PECOS PAC ID: 7315063328 Enrollment ID: I20100928000453 |
| Provider Name | Mumtaz F Raza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427083294 PECOS PAC ID: 2769508779 Enrollment ID: I20100928000474 |
| Provider Name | Lauren Shin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508812173 PECOS PAC ID: 1658469366 Enrollment ID: I20110323000650 |
| Provider Name | Cynthia M Russell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053489450 PECOS PAC ID: 9133305840 Enrollment ID: I20110513000554 |
| Provider Name | Xiaohong Yu |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1568614329 PECOS PAC ID: 9032362272 Enrollment ID: I20130121000103 |
| Provider Name | Mary Michelle Berkos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861670382 PECOS PAC ID: 0446480545 Enrollment ID: I20140312001121 |
| Provider Name | Sara R Danesi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942631304 PECOS PAC ID: 4880825603 Enrollment ID: I20140320000739 |
| Provider Name | Rachael L Benbrook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366862658 PECOS PAC ID: 5698998656 Enrollment ID: I20140520000066 |
| Provider Name | Vincent R Donlon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982020087 PECOS PAC ID: 8729202916 Enrollment ID: I20140609001569 |
| Provider Name | Shubhrajan S Wadyal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710144837 PECOS PAC ID: 0941427272 Enrollment ID: I20140811001928 |
| Provider Name | Lee E Patton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881864783 PECOS PAC ID: 5496974487 Enrollment ID: I20140924002263 |
| Provider Name | Damien A Dodd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144651829 PECOS PAC ID: 3476774316 Enrollment ID: I20141018000108 |
| Provider Name | Joanna I Czupryna |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730338617 PECOS PAC ID: 4385866573 Enrollment ID: I20141103001345 |
| Provider Name | Linda K Novak |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1760400105 PECOS PAC ID: 2567411127 Enrollment ID: I20150107002617 |
| Provider Name | Kelly M Demers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386838225 PECOS PAC ID: 0840516126 Enrollment ID: I20150304000461 |
| Provider Name | Madelyn M Burbank |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730521972 PECOS PAC ID: 4284948886 Enrollment ID: I20150727001489 |
| Provider Name | Karen L Schmidt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730374422 PECOS PAC ID: 9436467735 Enrollment ID: I20151007000734 |
| Provider Name | Sylvia Giron-gilliana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114262755 PECOS PAC ID: 1951601715 Enrollment ID: I20151130001379 |
| Provider Name | Syed Babar Hussain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437414695 PECOS PAC ID: 6901107168 Enrollment ID: I20160719000349 |
| Provider Name | Sean S Mcgrew |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528433786 PECOS PAC ID: 0749566057 Enrollment ID: I20170420001122 |
| Provider Name | Lisa Chico |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417366394 PECOS PAC ID: 1254698798 Enrollment ID: I20171208000048 |
| Provider Name | Elizabeth Erin Sita |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093132284 PECOS PAC ID: 2860797925 Enrollment ID: I20180904001954 |
| Provider Name | Morgan Sandhu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801376744 PECOS PAC ID: 7517210495 Enrollment ID: I20181023000385 |
| Provider Name | Mustansar Raza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326441072 PECOS PAC ID: 3072896000 Enrollment ID: I20181101001734 |
| Provider Name | Scott Paul Burgess |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770972028 PECOS PAC ID: 8224376363 Enrollment ID: I20190214001492 |
| Provider Name | Alisa Renee Prantner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629530043 PECOS PAC ID: 7315270923 Enrollment ID: I20190613003043 |
| Provider Name | Rohit P Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376924399 PECOS PAC ID: 9335452010 Enrollment ID: I20200316002423 |
| Provider Name | Kaitlyn Eichinger-murphy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972051894 PECOS PAC ID: 6406267368 Enrollment ID: I20201124003342 |
| Provider Name | Krists Klegeris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124604517 PECOS PAC ID: 1850794025 Enrollment ID: I20210726001991 |
| Provider Name | Meghan S Mayberry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518311836 PECOS PAC ID: 8729367859 Enrollment ID: I20210923001334 |
| Provider Name | Therese Draper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104201755 PECOS PAC ID: 9133527393 Enrollment ID: I20211001002896 |
| Provider Name | Rebecca Lepoff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538455936 PECOS PAC ID: 1355739897 Enrollment ID: I20211102001944 |
| Provider Name | Jennifer Ware |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1689292542 PECOS PAC ID: 5496146268 Enrollment ID: I20220105001625 |
| Provider Name | Christeena Chakkumcal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134889132 PECOS PAC ID: 1052705209 Enrollment ID: I20220303001986 |
| Provider Name | Melissa Ivins-lukse |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962100149 PECOS PAC ID: 7810361367 Enrollment ID: I20230323001139 |
| Provider Name | Gregory Arthur Ammon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033253901 PECOS PAC ID: 9335465319 Enrollment ID: I20231222000163 |
| Provider Name | Lauren Bantner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053875567 PECOS PAC ID: 4082064605 Enrollment ID: I20231222001313 |
| Provider Name | Megan Deligio |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598136475 PECOS PAC ID: 6103276621 Enrollment ID: I20231226001514 |
| Provider Name | Bradley Thomas Cramer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295389286 PECOS PAC ID: 5193175545 Enrollment ID: I20231227001281 |
| Provider Name | Nicholas G Zajak |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871864074 PECOS PAC ID: 1850741273 Enrollment ID: I20231228000284 |
| Provider Name | Christopher Zapata |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548613318 PECOS PAC ID: 6103276522 Enrollment ID: I20231228000345 |
| Provider Name | Marian Slahor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972071918 PECOS PAC ID: 2365892783 Enrollment ID: I20231228000392 |
| Provider Name | James D Sandstrom |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952314494 PECOS PAC ID: 0244680676 Enrollment ID: I20231228000510 |
| Provider Name | Gia Grimmitt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659396752 PECOS PAC ID: 6901256239 Enrollment ID: I20231228001139 |
| Provider Name | Sierra A. Gabrys |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619559036 PECOS PAC ID: 9133579477 Enrollment ID: I20231228001318 |
| Provider Name | Dipa Patel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467918037 PECOS PAC ID: 5496105744 Enrollment ID: I20231228001814 |
| Provider Name | Ericka Marie Ortiz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124358338 PECOS PAC ID: 3375993660 Enrollment ID: I20231228003171 |
| Provider Name | Theresa B Mikosz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003123167 PECOS PAC ID: 6709236094 Enrollment ID: I20231228003299 |
| Provider Name | Angela N Karamitos |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164608634 PECOS PAC ID: 5496105793 Enrollment ID: I20231228003495 |
| Provider Name | Clarice Marie La France |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245564699 PECOS PAC ID: 6901256205 Enrollment ID: I20231228003625 |
Wildflower Autism Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4591 W Higgins Rd Ste 120, Hoffman Estates, IL 60192 Phone: 815-600-1430 | |
Mind Matters Psychological Services Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1955 Haddam Pl, Hoffman Estates, IL 60169 Phone: 847-962-7714 | |
Lifebreath Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2300 S. Barrington Rd, Suite 400 Pmb 467, Hoffman Estates, IL 60169 Phone: 847-962-0306 | |
Ardent Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2500 W. Higgins Rd, Unit 105, Hoffman Estates, IL 60169 Phone: 888-870-1775 Fax: 847-349-1619 | |
Alliance Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2300 Barrington Rd, Suite 400, Hoffman Estates, IL 60169 Phone: 847-772-5486 | |
Evac Group Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2815 Forbs Ave Ste 107, Hoffman Estates, IL 60192 Phone: 804-937-3688 | |
Spectrum Youth And Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Illinois Blvd, Suite Ll-107, Hoffman Estates, IL 60194 Phone: 847-884-6212 Fax: 847-884-6687 |