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NPI Code Detail

MEDICARE: PRIZM BEHAVIORAL SERVICES, PC

MEDICARE: PRIZM BEHAVIORAL SERVICES, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center036114959IL
2261QM0850XAdult Mental Health Clinic/Center036114959IL
3261QM0855XAdolescent and Children Mental Health Clinic/Center036114959IL
4261QM2500XMedical Specialty Clinic/Center036114959IL
5305R00000XPreferred Provider Organization036114959IL
6261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)036114959IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306007778
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIZM BEHAVIORAL SERVICES, PC
Provider Business Mailing Address
First Line : PO BOX 2800
Second Line :
City : NAPERVILLE
State : IL
Zip : 60567-2800
Country : US
Telephone Number : 630-848-1200
Fax Number : 630-848-1208
Provider Business Practice Location Address
First Line : 230 MARTIN AVE
Second Line :
City : NAPERVILLE
State : IL
Zip : 60540-6536
Country : US
Telephone Number : 630-848-1200
Fax Number : 630-848-1208
Authorized Official
Title or Position : PSYCHIATRIST
Name : MS. ASMAT Z JAFRY
Credential : MD
Telephone Number : 630-848-1200
Provider Enumeration Date : 06/18/2008
Last Update Date : 03/27/2025

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