Active NPI
Anita C Holubiak
- Early Intervention Provider Agency
- Chicago, IL
National Provider Identifier
1316121155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Early Intervention Provider Agency
- Practice address
- 11825 S Maplewood Ave
Chicago, IL 60655-1525 - Phone
- (773) 239-4855
- Fax
- (773) 239-7505
- NPI assigned
- Dec 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | Primary |
Addresses
Primary practice location
11825 S Maplewood Ave
Chicago, IL 60655-1525
Mailing address
11825 S Maplewood Ave
Chicago, IL 60655-1525
Phone (773) 239-4855
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198713600000",
"number": "1316121155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11825 S MAPLEWOOD AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606551525",
"telephone_number": "773-239-4855",
"fax_number": "773-239-7505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11825 S MAPLEWOOD AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606551525",
"telephone_number": "773-239-4855",
"fax_number": "773-239-7505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLUBIAK",
"first_name": "ANITA",
"middle_name": "C",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-27",
"last_updated": "2007-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"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 Dec 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.