Healthcare Provider Details

I. General information

NPI: 1093653339
Provider Name (Legal Business Name): KAGAN PSYCHIATRIC SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1603 ORRINGTON AVE STE 652
EVANSTON IL
60201-3841
US

IV. Provider business mailing address

2709 W JARLATH ST
CHICAGO IL
60645-1317
US

V. Phone/Fax

Practice location:
  • Phone: 917-566-1045
  • Fax: 224-714-0630
Mailing address:
  • Phone: 917-566-1045
  • Fax: 224-714-0630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: YAFFA KAGAN
Title or Position: OWNER
Credential: APRN
Phone: 917-566-1045