Organization Active NPI

Nicasa, NFP

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Highland Park, IL
National Provider Identifier
1962952499
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
A-0614-0006 Issued in IL
Legal business name
NICASA, NFP
Practice address
1724 1St St
Highland Park, IL 60035-3202
Phone
(847) 433-1303
Fax
(847) 433-2324
NPI assigned
Oct 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Authorized official

Name
Linda Snelten
Title
Chief Operation Officer
Phone
(847) 546-6450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X A-0614-0006 IL Primary

Addresses

Primary practice location

1724 1St St
Highland Park, IL 60035-3202

Mailing address

31979 N Fish Lake Rd
Round Lake, IL 60073-9517
Phone (847) 546-6450

Other identifiers 1

IdentifierTypeStateIssuer
A-0614-0006MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Nicasa NFP13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

1724 1st St
Highland Park, IL 60035
Phone (847) 433-1303

Practitioners & affiliated clinicians

Practitioners 4

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": "1475798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617753600000",
    "number": "1962952499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31979 N FISH LAKE RD",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600739517",
            "telephone_number": "847-546-6450",
            "fax_number": "847-546-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 1ST ST",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353202",
            "telephone_number": "847-433-1303",
            "fax_number": "847-433-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICASA, NFP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A",
        "authorized_official_last_name": "SNELTEN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CHIEF OPERATION OFFICER",
        "authorized_official_telephone_number": "847-546-6450"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "A-0614-0006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A-0614-0006",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.