NPIMap

Organization Active NPI

Maine West School Based Health Center

  • Student Health Clinic/Center
  • Des Plaines, IL
National Provider Identifier
1750142204
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
MAINE WEST SCHOOL BASED HEALTH CENTER
Practice address
1755 S Wolf Rd Ste E103
Des Plaines, IL 60018-1923
Phone
(847) 803-5591
Fax
(847) 825-4060
NPI assigned
Jan 22, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Authorized official

Name
Amy B Carlson, APN
Title
Clinic Manager
Phone
(801) 803-9592

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

1755 S Wolf Rd Ste E103
Des Plaines, IL 60018-1923

Mailing address

1755 S Wolf Rd Ste E103
Des Plaines, IL 60018-1923
Phone (847) 803-5591

National Provider Directory

National Provider Directory
Tax ID family
Maine Township HS Dist 2075 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.

Locations

1755 S Wolf Rd
Des Plaines, IL 60018
Phone (847) 803-5901

1755 S Wolf Rd
Ste E103
Des Plaines, IL 60018
Phone (847) 803-5591

NPI Registry JSON

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1750142204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 S WOLF RD STE E103",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600181923",
            "telephone_number": "847-803-5591",
            "fax_number": "847-825-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 S WOLF RD STE E103",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600181923",
            "telephone_number": "847-803-5591",
            "fax_number": "847-825-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE WEST SCHOOL BASED HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "801-803-9592",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.