NPIMap

Organization Active NPI

South Suburban Council on Alcoholism and Substance Abuse

  • Substance Abuse Rehabilitation Facility
  • East Hazel Crest, IL
National Provider Identifier
1558362863
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
A-0621-0001-A Issued in IL
Legal business name
SOUTH SUBURBAN COUNCIL ON ALCOHOLISM AND SUBSTANCE ABUSE
Practice address
1909 Cheker SQ
East Hazel Crest, IL 60429-1442
Phone
(708) 647-3333
Fax
(708) 957-2614
NPI assigned
Aug 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Allen Joseph Sandusky, MA MBA
Title
President & Chief Executive Officer
Phone
(708) 647-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X A-0621-0001-A IL Primary

Addresses

Primary practice location

1909 Cheker SQ
East Hazel Crest, IL 60429-1442

Mailing address

1909 Cheker SQ
East Hazel Crest, IL 60429-1442
Phone (708) 647-3333

National Provider Directory

National Provider Directory
Tax ID family
The South Suburban Council on Alcoholism and Substance Abuse5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/sscouncil/r4/

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558362863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 CHEKER SQ",
            "city": "EAST HAZEL CREST",
            "state": "IL",
            "postal_code": "604291442",
            "telephone_number": "708-647-3333",
            "fax_number": "708-957-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 CHEKER SQ",
            "city": "EAST HAZEL CREST",
            "state": "IL",
            "postal_code": "604291442",
            "telephone_number": "708-647-3333",
            "fax_number": "708-957-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SUBURBAN COUNCIL ON ALCOHOLISM AND SUBSTANCE ABUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SANDUSKY",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "708-647-3300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA MBA"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "IL",
            "license": "A-0621-0001-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hazel Crest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.