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RISING PHOENIX MENTAL HEALTH PLLC
NPI 1669180493
Psychologist - Clinical in Burr Ridge, IL

Active since November 10, 2022
745 MCCLINTOCK DR STE 100, BURR RIDGE, IL 60527(630) 491-6846 Get Directions Write a Review

NPPES record last updated: November 14, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 14, 2025, Oct 1, 2024, Nov 17, 2022 and 1 more (4 updates tracked since 2022).

About Rising Phoenix Mental Health Pllc NPPES

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

RISING PHOENIX MENTAL HEALTH PLLC (NPI 1669180493), doing business as Ellie Mental Health, is a healthcare organization registered as a clinical in Burr Ridge, Illinois and active in the NPI registry since November 2022. The organization lists Mubeena Siddiqui, Credentialing Contact, as its authorized official.

NPPES Registry Identity

NPI1669180493
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameRISING PHOENIX MENTAL HEALTH PLLC
Location Address745 MCCLINTOCK DR STE 100Burr Ridge, IL 60527-0863
Mailing Address745 Mcclintock Dr Ste 100Burr Ridge, IL 60527-0863 · (630) 491-6846
Phone(630) 491-6846
Organization SubpartNo
Authorized OfficialMubeena SiddiquiCredentialing Contact · (630) 589-2730
Enumeration DateNovember 10, 2022
Last NPPES UpdateNovember 14, 20254 updates tracked since enumeration
NPPES CertifiedNovember 14, 2025
✔ NPI 1669180493 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
745 MCCLINTOCK DR STE 100, Burr Ridge, IL 60527
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Other Names 1

Doing Business AsEllie Mental Health

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Rising Phoenix Mental Health Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Rising Phoenix Mental Health PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Prabhdeep Kaur, LCSW
Clinical Social Worker
NPI 1851942155
745 MCCLINTOCK DR STE 100
Burr Ridge, IL 60527
(630) 491-6846
✔ PECOS✔ Accepts MedicareSame address
Krystel Segovia
Clinical Psychologist
NPI 1154034650
5 PICNIC CT
Bolingbrook, IL 60490
(331) 213-1075
✔ PECOS13 mi
Lauren Kaplan, PSYD
Clinical Psychologist
NPI 1992104376
13400 S ROUTE 59 STE 116-193
Plainfield, IL 60585
(630) 286-9556
✔ PECOS17 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Rising Phoenix Mental Health PLLC's NPI number?

The NPI number for Rising Phoenix Mental Health PLLC is 1669180493. It was assigned to this organization in the NPPES registry on November 10, 2022. The provider is doing business as Ellie Mental Health.

Where is Rising Phoenix Mental Health PLLC located?

Rising Phoenix Mental Health PLLC is located at 745 Mcclintock Dr Ste 100, Burr Ridge, IL 60527. The listed phone number is (630) 491-6846.

What is Rising Phoenix Mental Health PLLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Rising Phoenix Mental Health PLLC enrolled in Medicare?

Yes. Rising Phoenix Mental Health PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Rising Phoenix Mental Health PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Rising Phoenix Mental Health PLLC, in Clinical Psychologist and Clinical Social Worker. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Rising Phoenix Mental Health PLLC was last updated on November 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.