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ELEMENTAL MEDICAL CENTER LTD
NPI 1164935169
Psychiatry & Neurology - Child & Adolescent Psychiatry in Chicago, IL

Active since November 13, 2017
612 S WESTERN AVE APT 1, CHICAGO, IL 60612(331) 330-9955(708) 892-2909 Get Directions Write a Review

NPPES record last updated: October 22, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 17, 2020, Mar 17, 2018, Nov 13, 2017 (3 updates tracked since 2017).

About Elemental Medical Center Ltd NPPES

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

ELEMENTAL MEDICAL CENTER LTD (NPI 1164935169) is a healthcare organization registered as a child & adolescent psychiatry in Chicago, Illinois and active in the NPI registry since November 2017. The organization lists Martins A Adeoye, Ceo, as its authorized official.

NPPES Registry Identity

NPI1164935169
Entity TypeOrganization
Primary Taxonomy2084P0804X
Legal Business NameELEMENTAL MEDICAL CENTER LTD
Location Address612 S WESTERN AVE APT 1Chicago, IL 60612-4682
Mailing Address15010 S Ravinia Ave Ste 15Orland Park, IL 60462-5353 · (331) 330-9955
Phone(331) 330-9955
Fax(708) 892-2909
Organization SubpartNo
Authorized OfficialMartins A AdeoyeCeo · (331) 330-9955
Enumeration DateNovember 13, 2017
Last NPPES UpdateOctober 22, 20243 updates tracked since enumeration
NPPES CertifiedOctober 22, 2024
✔ NPI 1164935169 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in IL · 036103889
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X
612 S WESTERN AVE APT 1, Chicago, IL 60612
Open in Google Maps ↗

Other Identifiers 1

Medicaid036103889IL

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 MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

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

ALEXANDRA NEIRA
Counselor (Mental Health)
612 S WESTERN AVE APT 1
CHICAGO, IL 60612
Cook County (708) 364-0580
LEAH ANNETTE BONEY MS, QMHP
Counselor (Mental Health)
612 S WESTERN AVE APT 1
CHICAGO, IL 60612
Cook County (331) 330-9955
ELEMENTAL TREATMENT CENTER LTD
Clinic/Center (Federally Qualified Health Center (FQHC))
612 S WESTERN AVE APT 1
CHICAGO, IL 60612
Cook County (331) 330-9955
ELEMENTAL CENTER CARES INC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
612 S WESTERN AVE APT 1
CHICAGO, IL 60612
Cook County (708) 364-0580

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 Elemental Medical Center Ltd's NPI number?

The NPI number for Elemental Medical Center Ltd is 1164935169. It was assigned to this organization in the NPPES registry on November 13, 2017.

Where is Elemental Medical Center Ltd located?

Elemental Medical Center Ltd is located at 612 S Western Ave Apt 1, Chicago, IL 60612. The listed phone number is (331) 330-9955.

What is Elemental Medical Center Ltd's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

When was this NPI record last updated?

The NPPES record for Elemental Medical Center Ltd was last updated on October 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.