# SPECTRUM PRIVATE CLIENT

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SPECTRUM BA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1659086809
- **Legal business name:** SPECTRUM BA
- **Authorized official:** SHEILA MOFFETT (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (773) 316-2317

## Contact information

- **Practice address:** 201 E OGDEN AVE STE 118, HINSDALE, IL 60521-3776
- **Practice address phone:** (630) 270-7717
- **Mailing address:** 201 E OGDEN AVE STE 118, HINSDALE, IL 60521-3776
- **Mailing address phone:** (630) 270-7717

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | NULL | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/20/2023
- **Last updated:** 01/20/2023