NPIMap

Organization Active NPI

Individual Advocacy Group, Inc.

  • Adult Mental Health Clinic/Center
  • Romeoville, IL
National Provider Identifier
1801477799
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
INDIVIDUAL ADVOCACY GROUP, INC.
Practice address
30 Phelps Ave
Romeoville, IL 60446-1335
Phone
(815) 372-8950
Fax
(815) 372-8960
NPI assigned
Apr 21, 2021
Organization subpart
Yes
Parent organization
INDIVIDUAL ADVOCACY GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Authorized official

Name
Dr. David Heber Brooks, PHDNPI 1043432578
Title
Coo
Phone
(630) 759-0201

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

30 Phelps Ave
Romeoville, IL 60446-1335

Mailing address

1289 Windham Pkwy
Romeoville, IL 60446-1763
Phone (630) 759-0201

Other names 1

  • IAG Behavioral Health Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231026002852 IL Part B Supplier - Clinic/Group Practice 4284080243 Receives reassigned benefits from 4 practitioners
Practice locations: Romeoville, IL

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

30 Phelps Ave
Romeoville, IL 60446
Phone (630) 755-0053

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 10

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

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697760000000",
    "number": "1801477799",
    "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",
            "telephone_number": "630-759-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PHELPS AVE",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604461335",
            "telephone_number": "815-372-8950",
            "fax_number": "815-372-8960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUAL ADVOCACY GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDIVIDUAL ADVOCACY GROUP, INC.",
        "enumeration_date": "2021-04-21",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "HEBER",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "630-759-0201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IAG Behavioral Health Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "IAG Behavioral Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Romeoville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.