Active NPI
Amb Behavioral Health Prof. Corp.
- Community/Behavioral Health Agency
- Elgin, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- AMB BEHAVIORAL HEALTH PROF. CORP.
- Practice address
- 1111 Clover Hill LN
Elgin, IL 60120-2395 - Phone
- (312) 241-0554
- NPI assigned
- Aug 4, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kelly Fetherling, LCSW
- Title
- Ceo
- Phone
- (312) 241-0554
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
1111 Clover Hill LN
Elgin, IL 60120-2395
Mailing address
1111 Clover Hill LN
Elgin, IL 60120-2395
Phone (312) 241-0554
Other practice location 1
6912 Main St Ste 16
Downers Grove, IL 60516-3447
Phone (312) 241-0554
Other practice location 2
457 Coventry Lane
Suite 116
Elgin, IL 60120
Phone (312) 241-0554
National Provider Directory
National Provider DirectoryLocations
6912 Main St
Ste 16
Downers Grove, IL 60516
Phone (312) 241-0554
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Elgin, IL
- NPI 1215483979
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628035200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1628035200000",
"number": "1154095131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 CLOVER HILL LN",
"city": "ELGIN",
"state": "IL",
"postal_code": "601202395",
"telephone_number": "312-241-0554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 CLOVER HILL LN",
"city": "ELGIN",
"state": "IL",
"postal_code": "601202395",
"telephone_number": "312-241-0554"
}
],
"practiceLocations": [
{
"address_1": "6912 Main St Ste 16",
"address_purpose": "LOCATION",
"city": "Downers Grove",
"state": "IL",
"postal_code": "605163447",
"country_code": "US",
"telephone_number": "312-241-0554",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "457 Coventry Lane",
"address_2": "Suite 116",
"address_purpose": "LOCATION",
"city": "Elgin",
"state": "IL",
"postal_code": "60120",
"country_code": "US",
"telephone_number": "312-241-0554",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "AMB BEHAVIORAL HEALTH PROF. CORP.",
"organizational_subpart": "NO",
"enumeration_date": "2021-08-04",
"last_updated": "2021-08-04",
"certification_date": "2021-07-09",
"status": "A",
"authorized_official_last_name": "FETHERLING",
"authorized_official_first_name": "KELLY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "312-241-0554",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.