Healthcare Provider Details

I. General information

NPI: 1043198062
Provider Name (Legal Business Name): BETH PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20855 S LAGRANGE RD STE 205
FRANKFORT IL
60423-2043
US

IV. Provider business mailing address

20855 S LAGRANGE RD STE 205
FRANKFORT IL
60423-2043
US

V. Phone/Fax

Practice location:
  • Phone: 773-985-3539
  • Fax: 773-825-8411
Mailing address:
  • Phone: 773-985-3539
  • Fax: 773-825-8411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: OLAJUMOKE ELIZABETH ADEKOYA
Title or Position: DIRECTOR
Credential:
Phone: 402-417-5333