NPIMap

Organization Active NPI

Autism Clinic Corp

  • Clinical Social Worker
  • Frankfort, IL
National Provider Identifier
1093394124
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
AUTISM CLINIC CORP
Practice address
7255 Georgetown CMNS
Frankfort, IL 60423-3001
Phone
(708) 378-4550
Fax
(630) 920-0552
NPI assigned
Apr 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Authorized official

Name
Mrs. Shaden S Kassar, BCBANPI 1548632383
Title
Adminstor
Phone
(630) 631-9623

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

7255 Georgetown CMNS
Frankfort, IL 60423-3001

Mailing address

7255 Georgetown CMNS
Frankfort, IL 60423-3001
Phone (708) 378-4550

Other names 1

  • Autism Clinic Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624492800000",
    "number": "1093394124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7255 GEORGETOWN CMNS",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233001",
            "telephone_number": "708-378-4550",
            "fax_number": "630-920-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7255 GEORGETOWN CMNS",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233001",
            "telephone_number": "708-378-4550",
            "fax_number": "630-920-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTISM CLINIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "KASSAR",
        "authorized_official_first_name": "SHADEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINSTOR",
        "authorized_official_telephone_number": "630-631-9623",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autism Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Autism Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Frankfort, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.