Provider Demographics
NPI:1235235730
Name:OAKBROOK BEHAVIORAL HEALTH LTD
Entity Type:Organization
Organization Name:OAKBROOK BEHAVIORAL HEALTH LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-424-9482
Mailing Address - Street 1:PO BOX 5970
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-5312
Mailing Address - Country:US
Mailing Address - Phone:630-424-9204
Mailing Address - Fax:630-424-4783
Practice Address - Street 1:2803 BUTTERFIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1165
Practice Address - Country:US
Practice Address - Phone:630-424-9482
Practice Address - Fax:630-424-9482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL413000Medicare PIN