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AERIES HEALTHCARE OF ILLINOIS PHYSICIAN GROUP
NPI 1083841076
Psychologist - Prescribing (Medical) in Forest Park, IL

Active since June 17, 2009
8311 W ROOSEVELT RD, FOREST PARK, IL 60130(708) 209-4150 Get Directions Write a Review

NPPES record last updated: June 17, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Aeries Healthcare Of Illinois Physician Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AERIES HEALTHCARE OF ILLINOIS PHYSICIAN GROUP (NPI 1083841076) is a healthcare organization registered as a prescribing (medical) in Forest Park, Illinois and active in the NPI registry since June 2009. The organization lists Michael Nelson, Cfo, as its authorized official.

NPPES Registry Identity

NPI1083841076
Entity TypeOrganization
Primary Taxonomy103TP0016X
Legal Business NameAERIES HEALTHCARE OF ILLINOIS PHYSICIAN GROUP
Location Address8311 W ROOSEVELT RDForest Park, IL 60130
Mailing AddressPo Box 840936Dallas, TX 72584 · (708) 209-4152
Phone(708) 209-4150
Organization SubpartYesParent: Riveredege Hospital
Authorized OfficialMichael NelsonCfo · (708) 209-4156
Enumeration DateJune 17, 2009
✔ NPI 1083841076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Prescribing (Medical)Behavioral Health & Social Service Providers
Taxonomy Code103TP0016X
Definition

A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.

8311 W ROOSEVELT RD, Forest Park, IL 60130
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Other Identifiers 1

Medicare UPIN144009

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIANELLA V DIZON-MENEZES MD
Psychiatry & Neurology (Psychiatry)
8311 W ROOSEVELT RD, ADVANCED PSYCHIATRIC SERVICES
FOREST PARK, IL 60130
Cook County (708) 488-4968

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Aeries Healthcare Of Illinois Physician Group's NPI number?

The NPI number for Aeries Healthcare Of Illinois Physician Group is 1083841076. It was assigned to this organization in the NPPES registry on June 17, 2009.

Where is Aeries Healthcare Of Illinois Physician Group located?

Aeries Healthcare Of Illinois Physician Group is located at 8311 W Roosevelt Rd, Forest Park, IL 60130. The listed phone number is (708) 209-4150.

What is Aeries Healthcare Of Illinois Physician Group's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Prescribing (Medical), with taxonomy code 103TP0016X.

When was this NPI record last updated?

The NPPES record for Aeries Healthcare Of Illinois Physician Group was last updated on June 17, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.