| Nicasa, Nfp | |
|
1113 W Greenwood Ave Waukegan IL 60087-4908 | |
| (847) 244-4434 | |
| (847) 244-4098 |
| Full Name | Nicasa, Nfp |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1113 W Greenwood Ave, Waukegan, Illinois |
| Authorized Official Name and Position | Linda Snelten (CHIEF OPERATING OFFICER) |
| 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: (814) 546-6450 | Nicasa, Nfp 1113 W Greenwood Ave Waukegan IL 60087-4908 Ph: (847) 244-4434 |
| NPI Number | 1700336229 |
|---|---|
| Provider Enumeration Date | 10/07/2016 |
| Last Update Date | 04/07/2021 |
| Certification Date | 04/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700336229 | NPI | - | NPPES |
| 14012 | Other | IL | ILLINOIS DEPT OF HUMAN SERVICES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 14012 (Illinois) | Primary |
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