CLEMENTINE NAPERVILLE
NPI 1720629041
Clinic/Center - Adolescent and Children Mental Health in Naperville, IL

NPI Status: Active since October 08, 2019

Contact Information

27W121 80TH ST
NAPERVILLE, IL
ZIP 60565
Phone: (305) 663-1876

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  • Organization
  • Clinic/Center
  • Adolescent and Children Mental Health
  • CLIA Number: 14D2174054
  • CLIA Cert. Type: Other - RES ADULT MENTAL HEALTH
  • CLIA Exp. Date: 10-22-2027

About CLEMENTINE NAPERVILLE

This page provides the complete NPI Profile along with additional information for Clementine Naperville, a provider established in Naperville, Illinois operating as a Clinic/center, focusing in adolescent and children mental health . The healthcare provider is registered in the NPI registry with number 1720629041 assigned on October 2019. The practitioner's primary taxonomy code is 261QM0855X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Clementine Naperville. The authorized official of this NPI record is Mike Bagley (Chief Financial Officer)

NPI
1720629041
Provider Legal Name
MONTE NIDO ILLINOIS, LLC
Other Organization Name
CLEMENTINE NAPERVILLE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
27W121 80TH ST NAPERVILLE, IL 60565
Location Phone
(305) 663-1876
Mailing Address
6100 SW 76TH ST SOUTH MIAMI, FL 33143
Mailing Phone
(305) 663-1876
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-08-2019
Last Update Date
02-20-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Adolescent and Children Mental Health

Taxonomy Code
261QM0855X
Type
Ambulatory Health Care Facilities
Taxonomy Description
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MIKE BAGLEY

Authorized Official Title
CHIEF FINANCIAL OFFICER
Authorized Official Phone
(305) 663-1876

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
14D2174054
Facility Type
Other - RES ADULT MENTAL HEALTH
Certificate Effective Date
October 23, 2025
Certificate Expiration Date
October 22, 2027
Laboratory Director
KATHLEEN M. MCSHANE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Clementine Naperville to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1720629041, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
2
Doubled → 4
Pos 4
0
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
2
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
0
Unchanged
Pos 9
4
Doubled → 8
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 6 → 12 → 3 9 → 18 → 9 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 4 + 0 + 1 + 2 + 2 + 1 + 8 + 0 + 8 + 24 = 59

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1720629041.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1720629041, enumerated as an "organization" on October 08, 2019.

The provider is located at 27W121 80TH ST NAPERVILLE, IL 60565 and the phone number is (305) 663-1876.

Clinic/Center with taxonomy code 261QM0855X and a focus in Adolescent and Children Mental Health.