NPIMap

Organization Active NPI

Suppported Independence

  • Community/Behavioral Health Agency
  • Chicago, IL
National Provider Identifier
1114219037
Registry record updated May 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SUPPPORTED INDEPENDENCE
Practice address
30 S Wacker Dr
Suite 2200
Chicago, IL 60606-7413
Phone
(630) 667-7370
Fax
(312) 466-5601
NPI assigned
May 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2011

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

Authorized official

Name
Jessica Luckett
Title
President
Phone
(630) 667-7370

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

30 S Wacker Dr
Suite 2200
Chicago, IL 60606-7413

Mailing address

30 S Wacker Dr
Suite 2200
Chicago, IL 60606-7413
Phone (630) 667-7370

National Provider Directory

National Provider Directory
Tax ID family
Supported Independence4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

30 S Wacker Dr
Ste 2200
Chicago, IL 60606
Phone (312) 263-1018

NPI Registry JSON

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305072000000",
    "number": "1114219037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S WACKER DR",
            "address_2": "SUITE 2200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606067413",
            "telephone_number": "630-667-7370",
            "fax_number": "312-466-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S WACKER DR",
            "address_2": "SUITE 2200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606067413",
            "telephone_number": "630-667-7370",
            "fax_number": "312-466-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPPORTED INDEPENDENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-11",
        "last_updated": "2011-05-11",
        "status": "A",
        "authorized_official_last_name": "LUCKETT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-667-7370"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; 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.