NPIMap

Organization Active NPI

Individual Advocacy Group

  • Adult Mental Health Clinic/Center
  • East Moline, IL
National Provider Identifier
1659653319
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
INDIVIDUAL ADVOCACY GROUP
Practice address
4366 Kennedy Dr
East Moline, IL 61244-4250
Phone
(309) 796-1603
NPI assigned
Sep 19, 2011
Last updated
Mar 26, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
INDIVIDUAL ADVOCACY GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Authorized official

Name
Dr. David Brooks, PH D
Title
Coo
Phone
(630) 759-0201

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary
Community/Behavioral Health Agency 251S00000X 150.013257 IL

Addresses

Primary practice location

4366 Kennedy Dr
East Moline, IL 61244-4250

Mailing address

1289 Windham Pkwy
Romeoville, IL 60446-1763

Other names 1

  • IAG Behavioral Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Individual Advocacy Group Inc3 organizations share this tax ID, including this one
Part of
Individual Advocacy Group Inc

Other organizations with this tax ID 2

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

Locations

4366 Kennedy Dr
East Moline, IL 61244
Phone (309) 796-1603

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1316390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1659653319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1289 WINDHAM PKWY",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604461763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4366 KENNEDY DR",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612444250",
            "telephone_number": "309-796-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL ADVOCACY GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDIVIDUAL ADVOCACY GROUP, INC.",
        "enumeration_date": "2011-09-19",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "630-759-0201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH D"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "150.013257",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IAG Behavioral Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in East Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.