Provider Demographics
NPI:1346661139
Name:INSTITUTE OF NEUROBEHAVIOR SERVICES SC
Entity Type:Organization
Organization Name:INSTITUTE OF NEUROBEHAVIOR SERVICES SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:DR
Authorized Official - First Name:EVALDAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RADZEVICIUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-860-7017
Mailing Address - Street 1:14315 108TH AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5700
Mailing Address - Country:US
Mailing Address - Phone:708-586-9751
Mailing Address - Fax:
Practice Address - Street 1:14315 108TH AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-5700
Practice Address - Country:US
Practice Address - Phone:708-586-9751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-20
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 364SP0808X
IL0361260352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty