NICASA, NFP (NPI# 1700336229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700336229 |
| Entity Type | Organization |
| Organization Name | NICASA, NFP |
| Practice Address |
1113 W Greenwood Ave Waukegan IL 60087-4908 |
| Mailing Address |
31979 N Fish Lake Rd Round Lake IL 60073-9517 |
| Practice Telephone | 8472444434 |
| Practice Fax Number | 8472444098 |
| Mailing Telephone | 8145466450 |
| Mailing Fax Number | 8475466760 |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2016-10-07 |
| Authorized Official Name | LINDA SNELTEN (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 8475466450 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
14012 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ILLINOIS DEPT OF HUMAN SERVICES | 14012 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548674666 | Nicasa, Nfp | Community/Behavioral Health | 1632 23rd St, Zion, IL 60099-2345 | 2014-06-17 |
| 1194149542 | Nicasa, Nfp | Community/Behavioral Health | 1724 1st St, Highland Park, IL 60035-3202 | 2014-02-05 |
| 1841614294 | Nicasa, Nfp | Community/Behavioral Health | 2031 Dugdale Rd, North Chicago, IL 60064-1928 | 2014-02-05 |
| 1851715205 | Nicasa, Nfp | Community/Behavioral Health | 1113 W Greenwood Ave, Waukegan, IL 60087-4908 | 2014-02-05 |
| 1962952499 | Nicasa, Nfp | Clinic/Center | 1724 1st St, Highland Park, IL 60035-3202 | 2016-10-07 |
| 1225588759 | Nicasa, Nfp | Clinic/Center | 2900 N Main St, Buffalo Grove, IL 60089-2717 | 2016-10-07 |
| 1982154407 | Nicasa, Nfp | Clinic/Center | 2031 Dugdale Rd, North Chicago, IL 60064-1928 | 2016-10-07 |
| 1902220353 | Nicasa, Nfp | Community/Behavioral Health | 2900 N Main St, Buffalo Grove, IL 60089-2717 | 2014-02-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NICASA, NFP | 31979 N Fish Lake Rd, Round Lake, IL 60073-9517 |
| Street Address |
1113 W GREENWOOD AVE |
| City | WAUKEGAN |
| State | IL |
| Zip Code | 60087-4908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851715205 | Nicasa, Nfp | Community/Behavioral Health | 1113 W Greenwood Ave, Waukegan, IL 60087-4908 | 2014-02-05 |
| 1487135042 | Jamie Gallo-weinstein | Counselor | 1113 W Greenwood Ave, Waukegan, IL 60087-4908 | 2018-08-22 |
| 1083088256 | Marcos Carrillo | Counselor | 1113 W Greenwood Ave, Waukegan, IL 60087-4908 | 2015-11-25 |
| 1255705414 | Elizabeth Carbonell | Counselor | 1113 W Greenwood Ave, Waukegan, IL 60087-4908 | 2015-11-25 |
| 1871967190 | Laurie Kelly | Counselor | 1113 W Greenwood Ave, Waukegan, IL 60087-4908 | 2015-11-24 |
| 1568836138 | Michael Labellart | Counselor | 1113 W Greenwood Ave, Waukegan, IL 60087-4908 | 2015-11-19 |
| 1356714232 | Pamela Williams | Counselor | 1113 W Greenwood Ave, Waukegan, IL 60087-4908 | 2015-11-02 |
| 1386016673 | Nathaniel Brown | Counselor | 1113 W Greenwood Ave, Waukegan, IL 60087-4908 | 2015-10-26 |
| 1538531991 | Ferlando Mallory | Counselor | 1113 W Greenwood Ave, Waukegan, IL 60087-4908 | 2015-10-26 |
| 1952773319 | Stephanie Escobar | Counselor | 1113 W Greenwood Ave, Waukegan, IL 60087-4908 | 2015-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982268017 | Michael Donavan Wilson | Counselor | 200 North Lewis, Waukegan, IL 60087 | 2019-04-24 |
| 1114412160 | David B Fuentes | Specialist/Technologist | 2904 Wall Ave, Waukegan, IL 60087 | 2018-06-22 |
| 1578912713 | Fulton Family Dental, Ltd. | Dentist | 1308 Sunset Ave., Waukegan, IL 60087 | 2016-06-08 |
| 1902852825 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 3124 N Lewis Ave, Waukegan, IL 60087 | 2006-05-25 |
| 1396723565 | Daram H Reddy Md | Psychiatry & Neurology | 609 Greenwood Ave, Waukegan, IL 60087 | 2006-01-06 |
| 1609200328 | Rosa Margaret Uriostegui | Interpreter | 2117 Edgewood Rd, Waukegan, IL 60087-1442 | 2013-08-29 |
| 1518390871 | Mary Sol Enriquez | Developmental Therapist | 11307 W Edgewood Rd, Beach Park, IL 60087-1526 | 2013-08-09 |
| 1649894130 | Kelly M Ingram | Developmental Therapist | 38229 N North Ave, Beach Park, IL 60087-1662 | 2020-06-01 |
| 1467735209 | Kelly A. Holverson | Speech-Language Pathologist | 38286 N Geraghty Ave, Beach Park, IL 60087-1748 | 2011-09-27 |
| 1487669594 | Walgreen Co | Pharmacy | 39023 N Green Bay Rd, Beach Park, IL 60087-1978 | 2006-07-29 |
| Find all providers in zip 60087 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649806407 | The Josselyn Center Nfp | Clinic/Center | 415 Washington St Ste 200, Waukegan, IL 60085-5564 | 2020-03-12 |
| 1588297980 | Little City Foundation | Clinic/Center | 1301 S Lewis Ave, Waukegan, IL 60085-7814 | 2020-02-14 |
| 1811109184 | County of Lake | Clinic/Center | 3002 Grand Ave, Waukegan, IL 60085-2321 | 2007-05-07 |
| 1164446712 | County of Lake | Clinic/Center | 3010 Grand Ave, Waukegan, IL 60085-2321 | 2006-07-27 |
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| 1457959256 | Association for Individual Development | Clinic/Center | 708 N Bridge St, Yorkville, IL 60560-1105 | 2020-10-14 |
| 1285231555 | Association for Individual Development | Clinic/Center | 236 W Crystal Lake Ave, Crystal Lake, IL 60014-5847 | 2020-10-08 |
| 1386241123 | Envision Unlimited | Clinic/Center | 1801 N Spaulding Ave, Chicago, IL 60647-4926 | 2020-10-05 |
| 1881291789 | Jessica Weisbach, LLC | Clinic/Center | 2257 N Kedzie Blvd Apt 3, Chicago, IL 60647-2561 | 2020-10-04 |
| 1619574803 | Envision Unlimited | Clinic/Center | 2124 W 82nd Pl, Chicago, IL 60620-5358 | 2020-10-01 |
| 1144827320 | Envision Unlimited | Clinic/Center | 4919 N Clark St, Chicago, IL 60640-3514 | 2020-10-01 |
| 1194322370 | Envision Unlimited | Clinic/Center | 4911 S Hoyne Ave, Chicago, IL 60609-4721 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.