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PHOENIX CLINIC CHICAGO
NPI 1316632672
Clinic/Center - Mental Health (Including Community Mental Health Center) in Chicago, IL

Active since April 11, 2023
1136 S DELANO CT W STE B201, CHICAGO, IL 60605(773) 431-7397 Get Directions Write a Review

NPPES record last updated: April 11, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Phoenix Clinic Chicago NPPES

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

PHOENIX CLINIC CHICAGO (NPI 1316632672) is a healthcare organization registered as a mental health (including community mental health center) in Chicago, Illinois and active in the NPI registry since April 2023. The organization lists Taylor Ariel Pettway, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1316632672
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameTHE PHOENIX CLINIC NFP
Location Address1136 S DELANO CT W STE B201Chicago, IL 60605-3734
Mailing Address2436 W Cullom AveChicago, IL 60618-1604 · (773) 431-7397
Phone(773) 431-7397
Organization SubpartNo
Authorized OfficialTaylor Ariel PettwayExecutive Director · (773) 431-7397
Enumeration DateApril 11, 2023
NPPES CertifiedApril 11, 2023
✔ NPI 1316632672 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
1136 S DELANO CT W STE B201, Chicago, IL 60605
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Other Names 1

Doing Business AsPhoenix Clinic Chicago

Other Providers at the Same Location NPPES 20

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

CANDICE LOVE
Social Worker (Clinical)
1136 S DELANO CT W STE B201
CHICAGO, IL 60605
Cook County (773) 892-2353
LOVE AT HOME CARE LLC
In Home Supportive Care
1136 S DELANO CT W STE B201
CHICAGO, IL 60605
Cook County (312) 300-2954
KRISTEN WIDING LSW
Social Worker
1136 S DELANO CT W STE B201
CHICAGO, IL 60605
Cook County (773) 377-5577
BRIANA PLAISIMOND
Counselor (Mental Health)
1136 S DELANO CT W STE B201
CHICAGO, IL 60605
Cook County (312) 725-9980
JACQUELYN GEORGEN LCSW
Social Worker (Clinical)
1136 S DELANO CT W STE B201
CHICAGO, IL 60605
Cook County (773) 377-5577
MEL A DERMODY H.I.D.
Hearing Instrument Specialist
1136 S DELANO CT W STE B201
CHICAGO, IL 60605
Cook County (312) 528-3233
LAUREN ALEXANDER LCPC
Counselor (Mental Health)
1136 S DELANO CT W STE B201
CHICAGO, IL 60605
Cook County (872) 256-3153
LILLAR CHEVON BURTON
Counselor
1136 S DELANO CT W STE B201
CHICAGO, IL 60605
Cook County (708) 654-1929

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 The Phoenix Clinic Nfp's NPI number?

The NPI number for The Phoenix Clinic Nfp is 1316632672. It was assigned to this organization in the NPPES registry on April 11, 2023. The provider is doing business as Phoenix Clinic Chicago.

Where is The Phoenix Clinic Nfp located?

The Phoenix Clinic Nfp is located at 1136 S Delano Ct W Ste B201, Chicago, IL 60605. The listed phone number is (773) 431-7397.

What is The Phoenix Clinic Nfp's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for The Phoenix Clinic Nfp was last updated on April 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.