Active NPI
Cabs
- Community/Behavioral Health Agency
- Waukegan, IL
National Provider Identifier
1417396557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- CABS
- Practice address
- 3010 Grand Ave
Waukegan, IL 60085-2321 - Phone
- (847) 377-8950
- NPI assigned
- Jun 21, 2013
- 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
- Jerome Clark
- Title
- Student Intern
- Phone
- (847) 377-8950
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
3010 Grand Ave
Waukegan, IL 60085-2321
Mailing address
3010 Grand Ave
Waukegan, IL 60085-2321
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371772800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1371772800000",
"number": "1417396557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3010 GRAND AVE",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600852321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3010 GRAND AVE",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600852321",
"telephone_number": "847-377-8950"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CABS",
"organizational_subpart": "NO",
"enumeration_date": "2013-06-21",
"last_updated": "2013-06-21",
"status": "A",
"authorized_official_last_name": "CLARK",
"authorized_official_first_name": "JEROME",
"authorized_official_title_or_position": "STUDENT INTERN",
"authorized_official_telephone_number": "847-377-8950"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waukegan, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.