JOLIET BEHAVIORAL HEALTH – Child & Adolescent Psychiatry Physician, NPI 1245398502
Child & Adolescent Psychiatry Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for JOLIET BEHAVIORAL HEALTH
14 BAYBROOK LN
OAK BROOK, IL 605231607
Phone: (815) 725-1440
Fax: (815) 725-1550
Type: Mailing
Lalonde Avenue, Lombard, Addison Township, DuPage County, Illinois, 60148, United States
LOMBARD, IL 60148
Phone: (815) 725-1440
Fax: (815) 725-1550
Type: Mailing
Republic Avenue, Joliet, Will County, Illinois, 60435, United States
JOLIET, IL 60435
Phone: (815) 725-1440
Fax: (815) 725-1550
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2006-02-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-09-30 (616 days ago).
Enrollment records
1
Earliest due date
2024-09-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20060217000611 | O | Clinic/Group Practice | IL | 2024-09-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60523)
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