Youth Services Network

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

YOUTH SERVICES NETWORK

Practice address

107 N 3Rd St
Rockford, IL 61107-4010

Phone

(815) 986-1947

Fax

(815) 986-1954

NPI assigned

Nov 15, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Melissa Bucalo

Title

Administrative/Licensing Manager

Phone

(815) 986-1947

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CFC #1 Other name

Tax ID family

CFC 12 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Youth Services Network

  • Case Management Agency
  • Rockford, IL
  • NPI 1790001600
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573776000000",
    "number": "1043855851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N 3RD ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611074010",
            "telephone_number": "815-986-1947",
            "fax_number": "815-986-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N 3RD ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611074010",
            "telephone_number": "815-986-1947",
            "fax_number": "815-986-1954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH SERVICES NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-15",
        "last_updated": "2019-11-15",
        "status": "A",
        "authorized_official_last_name": "BUCALO",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "ADMINISTRATIVE/LICENSING MANAGER",
        "authorized_official_telephone_number": "815-986-1947"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3000005",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CFC #1",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melissa Noel Young, PSY.D.
• Stacie Michelle Young, LPC
• Uthman Mohammad Younis, MD
• Angie Youssef Hernandez, DPM
• Youth Service Bureau of Illinois Valley
• Youth Services Network
• Lindsay Marie Yowell
• Zhichun Yu, DMD
• Veronika Yurchenko, PHARMD
• Fazlur R. Zahurullah, MD

• Case Management Agency in Rockford, IL
• Providers in Rockford, IL by specialty
• Case Management Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.