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

Q: What is Monte Nido Illinois, LLC's NPI number?

The NPI number for Monte Nido Illinois, LLC is 1720629041. It was assigned to this organization in the NPPES registry on October 8, 2019. The provider is doing business as Clementine Naperville.

Q: What is Monte Nido Illinois, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

Active since October 08, 2019CLIA 14D2174054 · Waiver

27W121 80TH ST, NAPERVILLE, IL 60565(305) 663-1876 Get Directions Write a Review

NPPES record last updated: February 20, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 20, 2020, Oct 8, 2019 (2 updates tracked since 2019).

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About Clementine Naperville NPPES

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

CLEMENTINE NAPERVILLE (NPI 1720629041) is a healthcare organization registered as an adolescent and children mental health in Naperville, Illinois and active in the NPI registry since October 2019. The organization holds a CLIA Waiver certificate valid through October 22, 2027 and lists Mike Bagley, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1720629041

Entity TypeOrganization

Primary Taxonomy261QM0855X

Legal Business NameMONTE NIDO ILLINOIS, LLC

Location Address27W121 80TH STNaperville, IL 60565-1270

Mailing Address6100 Sw 76th StSouth Miami, FL 33143-5002 · (305) 663-1876

Phone(305) 663-1876

Organization SubpartNo

Authorized OfficialMike BagleyChief Financial Officer · (305) 663-1876

Enumeration DateOctober 8, 2019

Last NPPES UpdateFebruary 20, 20202 updates tracked since enumeration

✔ NPI 1720629041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities

Taxonomy Code261QM0855X

Definition

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.

27W121 80TH ST, Naperville, IL 60565

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Other Names 1

Doing Business AsClementine Naperville

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2174054

Clementine Naperville · Winfield, IL

Active · expires Oct 22, 2027

CLIA Number14D2174054

Laboratory TypeRes Adult Mental Health

Certificate Effective DateOctober 23, 2025

Certificate Expiration DateOctober 22, 2027

Laboratory DirectorKathleen M. Mcshane

Laboratory Phone(305) 663-1876

Laboratory LocationClementine Naperville28w510 Washington Ave, Winfield, IL 60190

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Monte Nido Illinois, LLC's NPI number?

The NPI number for Monte Nido Illinois, LLC is 1720629041. It was assigned to this organization in the NPPES registry on October 8, 2019. The provider is doing business as Clementine Naperville.

Where is Monte Nido Illinois, LLC located?

Monte Nido Illinois, LLC is located at 27w121 80th St, Naperville, IL 60565. The listed phone number is (305) 663-1876.

What is Monte Nido Illinois, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

Does Monte Nido Illinois, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2174054) is associated with this NPI, valid through October 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Monte Nido Illinois, LLC was last updated on February 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.