| Nicasa Nfp | |
|
31979 N Fish Lake Rd Round Lake IL 60073-9517 | |
| (847) 546-6450 | |
| (847) 546-6760 |
| Full Name | Nicasa Nfp |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 31979 N Fish Lake Rd, Round Lake, Illinois |
| Authorized Official Name and Position | Linda Snelten (COO) |
| Authorized Official Contact | 8475466450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicasa Nfp 31979 N Fish Lake Rd Round Lake IL 60073-9517 Ph: (847) 546-6450 | Nicasa Nfp 31979 N Fish Lake Rd Round Lake IL 60073-9517 Ph: (847) 546-6450 |
| NPI Number | 1952798431 |
|---|---|
| Provider Enumeration Date | 04/22/2015 |
| Last Update Date | 04/07/2021 |
| Certification Date | 04/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952798431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 14012 (Illinois) | Primary |
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