| Nicasa, Nfp | |
|
1632 23rd St Zion IL 60099-2345 | |
| (847) 872-2830 | |
| (847) 731-7785 |
| Full Name | Nicasa, Nfp |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 1632 23rd St, Zion, Illinois |
| Authorized Official Name and Position | Linda Snelten (CHIEF OPERATING OFICER) |
| 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 1632 23rd St Zion IL 60099-2345 Ph: (847) 872-2830 |
| NPI Number | 1548674666 |
|---|---|
| Provider Enumeration Date | 06/17/2014 |
| Last Update Date | 04/06/2021 |
| Certification Date | 04/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548674666 | NPI | - | NPPES |
| C/A-0614-0007-A | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | A-0614-0007-A (Illinois) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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