Nicasa

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

NICASA

Practice address

31979 N Fish Lkae Rd
Round Lake, IL 60073

Phone

(847) 546-6450

Fax

(847) 546-6760

NPI assigned

May 3, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Bruce Johnson

Title

Coo

Phone

(847) 546-6450

Specialties & licenses 2

Addresses

Other identifiers 8

Tax ID family

Nicasa NFP13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

• Nicasa

  • Voluntary or Charitable Agency
  • Round Lake, IL
  • NPI 1912950460
  NPD tax ID
• Nicasa - Bridge House

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Waukegan, IL
  • NPI 1437705746
  NPD tax ID
• Nicasa NFP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Round Lake, IL
  • NPI 1952798431
  NPD tax ID
• Nicasa, NFP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Highland Park, IL
  • NPI 1194149542
  NPD tax ID
• Nicasa, NFP

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Buffalo Grove, IL
  • NPI 1225588759
  NPD tax ID
• Nicasa, NFP

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Zion, IL
  • NPI 1548674666
  NPD tax ID
• Nicasa, NFP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waukegan, IL
  • NPI 1700336229
  NPD tax ID
• Nicasa, NFP

  • Substance Use Disorder Rehabilitation Clinic/Center
  • North Chicago, IL
  • NPI 1841614294
  NPD tax ID
• Nicasa, NFP

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Waukegan, IL
  • NPI 1851715205
  NPD tax ID
• Nicasa, NFP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Buffalo Grove, IL
  • NPI 1902220353
  NPD tax ID
• Nicasa, NFP

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Highland Park, IL
  • NPI 1962952499
  NPD tax ID
• Nicasa, NFP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North Chicago, IL
  • NPI 1982154407
  NPD tax ID

Practitioners 1

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

• Rebecca Craig, LCPC

  • Professional Counselor
  • Round Lake, IL
  • NPI 1326542697
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1457573099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31979 N FISH LKAE RD",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "60073",
            "telephone_number": "847-546-6450",
            "fax_number": "847-546-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31979 N FISH LKAE RD",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "60073",
            "telephone_number": "847-546-6450",
            "fax_number": "847-546-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICASA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "847-546-6450",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "CA06140005A",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CA06140002A",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CA06140005A",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS",
            "identifier": "A06140005A",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS",
            "identifier": "A06140004A",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CA06140001A",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS",
            "identifier": "A06140003A",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS",
            "identifier": "A06140001A",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS",
            "identifier": "A06140002A",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lina Milrud, D.C.
• Min H. Lin, M.D. LTD.
• National Medical Care Inc
• Christine Newton
• Alexander Tam-Phan Nguyen, PHARMD
• Nicasa
• Nicasa NFP
• Nikogosian Vision Care
• Jimmy N Nkutu
• Michele Rose Norris, M.A., CCC-SLP

• Substance Use Disorder Rehabilitation Clinic/Center in Round Lake, IL
• Providers in Round Lake, IL by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.

Verify at the official NPI Registry.