Autism Services of the North Shore, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

146009727 Issued in IL

Legal business name

AUTISM SERVICES OF THE NORTH SHORE, INC.

Practice address

844 Hinman Ave Apt 1
Evanston, IL 60202-5914

Phone

(847) 869-1505

NPI assigned

Aug 15, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Mirela Lucia Vesa, MA

Title

President

Phone

(847) 869-1505

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1250294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251504000000",
    "number": "1114159746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 HINMAN AVE APT 1",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602025914",
            "telephone_number": "847-869-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 HINMAN AVE APT 1",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602025914",
            "telephone_number": "847-869-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTISM SERVICES OF THE NORTH SHORE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-15",
        "last_updated": "2009-08-29",
        "status": "A",
        "authorized_official_last_name": "VESA",
        "authorized_official_first_name": "MIRELA",
        "authorized_official_middle_name": "LUCIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-869-1505",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "IL",
            "license": "146009727",
            "primary": true
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "IL",
            "license": "056004090",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "IL",
            "license": "070011141",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "IL",
            "license": "146003437",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Evanston, IL
• Providers in Evanston, IL by specialty
• Developmentally Disabled Services Day Training Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2009; 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.