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CHICAGO BEHAVIORAL CLINIC LLC
NPI 1821540428
Psychologist - Clinical in Chicago, IL

Active since October 29, 2016
2502 N CLARK ST STE 206, CHICAGO, IL 60614(773) 850-0294 Get Directions Write a Review

NPPES record last updated: June 1, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 1, 2020, Aug 29, 2019, Jun 6, 2019 and 1 more (4 updates tracked since 2016).

About Chicago Behavioral Clinic Llc NPPES

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

CHICAGO BEHAVIORAL CLINIC LLC (NPI 1821540428) is a healthcare organization registered as a clinical in Chicago, Illinois and active in the NPI registry since October 2016. The organization lists Azadeh Ghaffari, Clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1821540428
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameCHICAGO BEHAVIORAL CLINIC LLC
Location Address2502 N CLARK ST STE 206Chicago, IL 60614-1850
Mailing Address2502 N Clark St Ste 206Chicago, IL 60614-1850 · (773) 850-0294
Phone(773) 850-0294
Organization SubpartNo
Authorized OfficialAzadeh GhaffariClinical Psychologist · (773) 850-0294
Enumeration DateOctober 29, 2016
Last NPPES UpdateJune 1, 20204 updates tracked since enumeration
NPPES CertifiedJune 1, 2020
✔ NPI 1821540428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in IL · 071008535
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.
2502 N CLARK ST STE 206, Chicago, IL 60614
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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)

Chicago Behavioral Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Chicago Behavioral Clinic LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Joanna Buscemi, PHD
Clinical Psychologist
NPI 1497473649
2502 N CLARK ST STE 206
Chicago, IL 60614
(773) 850-0294
✔ PECOS✔ Accepts MedicareSame address
Azadeh Ghaffari, PH.D.
Clinical Psychologist
NPI 1811236755
2502 N CLARK ST STE 206
Chicago, IL 60614
(773) 850-0294
✔ PECOS✔ Accepts MedicareSame address
Kendall Martin, PSYD
Clinical Psychologist
NPI 1710859970
2502 N CLARK ST STE 206
Chicago, IL 60614
(773) 850-0294
✔ PECOS✔ Accepts MedicareSame address
Sarah Sarhaddi, PSYD
Clinical Psychologist
NPI 1184983397
1200 S YORK ST
Elmhurst, IL 60126
(331) 221-6134
✔ PECOS✔ Accepts Medicare16 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 Chicago Behavioral Clinic LLC's NPI number?

The NPI number for Chicago Behavioral Clinic LLC is 1821540428. It was assigned to this organization in the NPPES registry on October 29, 2016.

Where is Chicago Behavioral Clinic LLC located?

Chicago Behavioral Clinic LLC is located at 2502 N Clark St Ste 206, Chicago, IL 60614. The listed phone number is (773) 850-0294.

What is Chicago Behavioral Clinic LLC's specialty?

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

Is Chicago Behavioral Clinic LLC enrolled in Medicare?

Yes. Chicago Behavioral Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Chicago Behavioral Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Clinical Psychologist, reassign their Medicare billing to Chicago Behavioral Clinic LLC. 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, 3 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 Chicago Behavioral Clinic LLC was last updated on June 1, 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.