Individual provider Active NPI

Ralph Robinson, CADC, MISA

  • Addiction (Substance Use Disorder) Counselor
  • Chicago, IL
National Provider Identifier
1194253922
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
25380 Issued in IL
Practice address
1015 W Lawrence Ave
Chicago, IL 60640-5017
Phone
(773) 275-2586
Fax
(773) 275-3689
NPI assigned
May 24, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 25380 IL Primary

Addresses

Primary practice location

1015 W Lawrence Ave
Chicago, IL 60640-5017

Mailing address

1015 W Lawrence Ave
Chicago, IL 60640-5017
Phone (773) 275-2586

Other practice location 1

4750 N Sheridan Rd
Chicago, IL 60640-7528
Phone (773) 275-2586 ext. 1834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25380ILMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1194253922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 W LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405017",
            "telephone_number": "773-275-2586",
            "fax_number": "773-275-3689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 W LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405017",
            "telephone_number": "773-275-2586",
            "fax_number": "773-275-3689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4750 N Sheridan Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606407528",
            "country_code": "US",
            "telephone_number": "773-275-2586 x1834",
            "fax_number": "773-275-8639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "RALPH",
        "name_prefix": "Mr.",
        "credential": "CADC, MISA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "25380",
            "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 Mar 17, 2018; 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.