Organization Active NPI

Deborah'S Place

  • Community/Behavioral Health Agency
  • Chicago, IL
National Provider Identifier
1568828291
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
149.007559 Issued in IL
Legal business name
DEBORAH'S PLACE
Practice address
2822 W Jackson Blvd
Chicago, IL 60612-3653
Phone
(773) 722-5080
NPI assigned
Jan 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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

Authorized official

Name
Ms. Katharine C Booton Wilson, LCSW
Title
Chief Strategy Officer
Phone
(773) 638-6392

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 149.007559 IL
Case Management Agency 251B00000X 149.011208 IL
Case Management Agency 251B00000X 149.016615 IL
Case Management Agency 251B00000X 149.015965 IL
Case Management Agency 251B00000X 150.015350 IL
Community/Behavioral Health Agency 251S00000X 149.007559 IL Primary
Community/Behavioral Health Agency 251S00000X 149.011208 IL
Community/Behavioral Health Agency 251S00000X 149.016615 IL
Community/Behavioral Health Agency 251S00000X 149.015965 IL
Community/Behavioral Health Agency 251S00000X 150.015350 IL

Addresses

Primary practice location

2822 W Jackson Blvd
Chicago, IL 60612-3653

Mailing address

1456 W Oakdale Ave
Chicago, IL 60657-4119
Phone (773) 348-9011

National Provider Directory

National Provider Directory
Tax ID family
Deborah'S Place3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1456 W Oakdale Ave
Chicago, IL 60657

NPI Registry JSON

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452470400000",
    "number": "1568828291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 W OAKDALE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574119",
            "telephone_number": "773-348-9011",
            "fax_number": "773-348-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2822 W JACKSON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123653",
            "telephone_number": "773-722-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH'S PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-01-11",
        "status": "A",
        "authorized_official_last_name": "BOOTON WILSON",
        "authorized_official_first_name": "KATHARINE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF STRATEGY OFFICER",
        "authorized_official_telephone_number": "773-638-6392",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "IL",
            "license": "149.007559",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "IL",
            "license": "149.011208",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "IL",
            "license": "149.016615",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "IL",
            "license": "149.015965",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "IL",
            "license": "150.015350",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "149.007559",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "149.011208",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "149.016615",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "149.015965",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "150.015350",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; 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.