Healthcare Provider Details

I. General information

NPI: 1801600333
Provider Name (Legal Business Name): PERSONAL GROWTH PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 WARRENVILLE RD STE 419
LISLE IL
60532-3640
US

IV. Provider business mailing address

3030 WARRENVILLE RD STE 419
LISLE IL
60532-3640
US

V. Phone/Fax

Practice location:
  • Phone: 708-232-0668
  • Fax:
Mailing address:
  • Phone: 708-232-0668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JOSEPH PEPITONE
Title or Position: OPERATING MEMBER
Credential: MD
Phone: 708-232-0668