MEDICARE: ALLIGN BEHAVIORAL HEALTH GROUP LLC

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1699638064
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIGN BEHAVIORAL HEALTH GROUP LLC

Provider Business Mailing Address
First Line	:	3432 W DIVERSEY AVE # 2F
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-1221
Country	:	US
Telephone Number	:	312-262-6926
Fax Number	:	312-585-8412

Provider Business Practice Location Address
First Line	:	3432 W DIVERSEY AVE # 2F
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-1221
Country	:	US
Telephone Number	:	312-262-6926
Fax Number	:	312-585-8412

Authorized Official
Title or Position	:	CLINICAL OPERATIONS
Name	:	NGOZI ADINDU
Credential	:	APRN
Telephone Number	:	312-262-6926

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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