Healthcare Provider Details

I. General information

NPI: 1528032828
Provider Name (Legal Business Name): BEHAVIORAL MEDICAL ASSOCIATES, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4711 GOLF RD SUITE 700
SKOKIE IL
60076-1224
US

IV. Provider business mailing address

2313 CARRINGTON WAY
GLENVIEW IL
60026-1010
US

V. Phone/Fax

Practice location:
  • Phone: 847-674-4704
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: PETER FINK
Title or Position: PRESIDENT
Credential: MD
Phone: 847-674-4704