Provider Demographics
NPI:1043198062
Name:BETH PSYCHIATRY LLC
Entity type:Organization
Organization Name:BETH PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OLAJUMOKE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ADEKOYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-417-5333
Mailing Address - Street 1:20855 S LAGRANGE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-2043
Mailing Address - Country:US
Mailing Address - Phone:773-985-3539
Mailing Address - Fax:773-825-8411
Practice Address - Street 1:20855 S LAGRANGE RD STE 205
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-2043
Practice Address - Country:US
Practice Address - Phone:773-985-3539
Practice Address - Fax:773-825-8411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-26
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No251S00000XAgenciesCommunity/Behavioral Health