Active NPI
Annette Bailey
- Addiction (Substance Use Disorder) Counselor
- Homewood, IL
National Provider Identifier
1467920132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 30745
- Practice address
- 935 W 175TH Street
Suite 300
Homewood, IL 60430 - Phone
- (708) 730-4255
- NPI assigned
- Nov 11, 2018
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 30745 | IL | Primary |
Addresses
Primary practice location
935 W 175TH Street
Suite 300
Homewood, IL 60430
Mailing address
935 W 175TH Street
Suite 300
Homewood, IL 60430
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30745 | IL | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542067200000",
"number": "1467920132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "935 W 175TH STREET",
"address_2": "SUITE 300",
"city": "HOMEWOOD",
"state": "IL",
"postal_code": "60430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "935 W 175TH STREET",
"address_2": "SUITE 300",
"city": "HOMEWOOD",
"state": "IL",
"postal_code": "60430",
"telephone_number": "708-730-4255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "ANNETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-11",
"last_updated": "2018-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IL",
"license": "30745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homewood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.