NPIMap

Organization Active NPI

Ican Community Services Inc. NFP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • South Holland, IL
National Provider Identifier
1326544735
Registry record updated Apr 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
17009 Issued in IL
Legal business name
ICAN COMMUNITY SERVICES INC. NFP
Practice address
15475 S Park Ave Ste 109
South Holland, IL 60473-1377
Phone
(708) 596-5680
Fax
(708) 596-5687
NPI assigned
Apr 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2018

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

Authorized official

Name
Dr. Anthony Olujimi, MD,MPH,CADCNPI 1114432564
Title
Ceo
Phone
(708) 596-5680

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)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 17009 IL Primary

Addresses

Primary practice location

15475 S Park Ave Ste 109
South Holland, IL 60473-1377

Mailing address

15475 S Park Ave Ste 109
South Holland, IL 60473-1377
Phone (708) 596-5680

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522800000000",
    "number": "1326544735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15475 S PARK AVE STE 109",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731377",
            "telephone_number": "708-596-5680",
            "fax_number": "708-596-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15475 S PARK AVE STE 109",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731377",
            "telephone_number": "708-596-5680",
            "fax_number": "708-596-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAN COMMUNITY SERVICES INC. NFP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-04",
        "last_updated": "2018-04-04",
        "status": "A",
        "authorized_official_last_name": "OLUJIMI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-596-5680",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD,MPH,CADC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "17009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Holland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.