CHILDHOOD TRAUMA TREATMENT PROGRAM OF ADVOCATE HEALTH & HOSPITALS CORP – NPI #1114242112
Clinic/Center

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

Health Care Provider Taxonomy Code for Clinic/Center

CHILDHOOD TRAUMA TREATMENT PROGRAM OF ADVOCATE HEALTH & HOSPITALS CORP is an AHC clinic located in OAK LAWN, IL. NPPES has assigned the NPI number 1114242112 to CHILDHOOD TRAUMA TREATMENT PROGRAM OF ADVOCATE HEALTH & HOSPITALS CORP on April 01, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. CHILDHOOD TRAUMA TREATMENT PROGRAM OF ADVOCATE HEALTH & HOSPITALS CORP is also known by the name CHILDHOOD TRAUMA TREATMENT PROGRAM. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QM0855X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Adolescent and Children Mental Health

The NPI profile was previously updated about 4 years ago on Oct 27, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CHILDHOOD TRAUMA TREATMENT PROGRAM OF ADVOCATE HEALTH & HOSPITALS CORP below.

NPI Profile for
CHILDHOOD TRAUMA TREATMENT PROGRAM OF ADVOCATE HEALTH & HOSPITALS CORP

NPI Number
1114242112
Enumeration Date

(more than 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CHILDHOOD TRAUMA TREATMENT PROGRAM OF ADVOCATE HEALTH & HOSPITALS CORP
Other Name: CHILDHOOD TRAUMA TREATMENT PROGRAM
Primary location
4700 W 95TH ST STE LL5
OAK LAWN, IL 60453-2575
Phone: (800) 216-1110 Fax: (708) 346-4868
Mailing address
PO BOX 776
CHILDHOOD TRAUMA TREATMENT PROGRAM
OAK LAWN, IL 60454-0776
Phone: (800) 216-1110 Fax: (708) 346-4868
Organization Subpart
Yes - CHILDHOOD TRAUMA TREATMENT PROGRAM OF ADVOCATE HEALTH & HOSPITALS CORP is subpart of another organization.
Authorized Official
SARA SKINNER
CLINICAL MANAGER
Phone: (800) 216-1110
Updated
Certification Date
Oct 27, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM0855X
- Clinic/Center / Adolescent and Children Mental Health (Primary)
261QM0850X
- Clinic/Center / Adult Mental Health
261QM0801X
- Clinic/Center / Mental Health (Including Community Mental Health Center)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
WORK EMAIL
Content Type
OTHER
Affiliation
N
Endpoint Location
4700 W 95TH ST STE LL5,
OAK LAWN, IL 77025-1669