Healthcare Provider Details

I. General information

NPI: 1164339628
Provider Name (Legal Business Name): POLARIS BEHAVIORAL HEALTH SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3635 BREITWIESER LN
NAPERVILLE IL
60564
US

IV. Provider business mailing address

3635 BREITWIESER LN
NAPERVILLE IL
60564-8225
US

V. Phone/Fax

Practice location:
  • Phone: 312-439-1741
  • Fax: 708-874-8078
Mailing address:
  • Phone: 312-439-1741
  • Fax: 708-818-6256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARY-ELLEN MARTINEZ
Title or Position: PRESIDENT/OWNER
Credential: PSY.D
Phone: 312-439-1741