=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588535140
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PINNACLEMENTALHEALTH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2025
-----------------------------------------------------
Last Update Date | 02/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16537 OAK PARK AVE
-----------------------------------------------------
City | TINLEY PARK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60477-1752
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-829-5731
-----------------------------------------------------
Fax | 773-829-5731
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1146 HEATHER HILL CRES
-----------------------------------------------------
City | FLOSSMOOR
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60422-1452
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-829-5731
-----------------------------------------------------
Fax | 773-829-5731
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PARTNER (RESPONSIBLE)
-----------------------------------------------------
Name | NGOZI COMFORT IDIA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 773-829-5731
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------