Organization Active NPI

B & B Spaulding LLC

  • Community/Behavioral Health Agency
  • Deer Park, IL
National Provider Identifier
1902106750
Registry record updated Feb 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
B & B SPAULDING LLC
Practice address
20587 N Swansway
Deer Park, IL 60010-3768
Phone
(847) 421-0252
Fax
(847) 847-7501
NPI assigned
Oct 27, 2010
Last updated
Feb 14, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2018

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

Authorized official

Name
Robert Spaulding, MBA, CFCE
Title
Manager
Phone
(847) 421-0252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

20587 N Swansway
Deer Park, IL 60010-3768

Mailing address

20587 N Swansway
Deer Park, IL 60010-3768
Phone (847) 421-0252

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110203001142 IL Part B Supplier - Clinic/Group Practice 7810177177 Receives reassigned benefits from 4 practitioners
Practice locations: Deer Park, IL

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Healthcare Plus CorporationRolling Meadows, IL, CCN 147738 Home health agency 5% Or Greater Direct Ownership Interest (15%) Jan 1, 2008

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 6

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": "1288137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518566400000",
    "number": "1902106750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20587 N SWANSWAY",
            "city": "DEER PARK",
            "state": "IL",
            "postal_code": "600103768",
            "telephone_number": "847-421-0252",
            "fax_number": "847-847-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20587 N SWANSWAY",
            "city": "DEER PARK",
            "state": "IL",
            "postal_code": "600103768",
            "telephone_number": "847-421-0252",
            "fax_number": "847-847-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B & B SPAULDING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-27",
        "last_updated": "2018-02-14",
        "status": "A",
        "authorized_official_last_name": "SPAULDING",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-421-0252",
        "authorized_official_credential": "MBA, CFCE"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, IL

Sources for this page

Verify at the official NPI Registry.