Chicago Area Behavioral Health Services Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149015078 Issued in IL

Legal business name

CHICAGO AREA BEHAVIORAL HEALTH SERVICES INC

Practice address

5658 S Kolin Ave Unit 2
Chicago, IL 60629-4839

Phone

(708) 876-7525

Fax

(708) 544-0630

NPI assigned

Jun 29, 2016

Organization subpart

No

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

Authorized official

Name

Augustus EdehNPI 1275807158

Title

LCSW

Phone

(773) 412-7420

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 2

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

• Augustus C Edeh, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1275807158
  Medicare reassignment Care Compare group NPD Authorized official
• Iyare Kingsley Imanlihen, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1114322823
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1518318666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W SAINT CHARLES RD",
            "address_2": "SUITE 123",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601482288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5658 S KOLIN AVE UNIT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606294839",
            "telephone_number": "708-876-7525",
            "fax_number": "708-544-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO AREA BEHAVIORAL HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-29",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "EDEH",
        "authorized_official_first_name": "AUGUSTUS",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "773-412-7420"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.