Nicasa

LBN: Nicasa
Nicasa is an health care organization with primary practice located at 31979 N Fish Lkae Rd , Round Lake IL 60073. The organization recently has 2 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder is the primary health care specialty. Nicasa can be contacted via phone (847) 546-6450, or through Johnson, Bruce via phone (847) 546-6450.

Contact Information

Primary practice address
31979 N Fish Lkae Rd Round Lake IL 60073
Phone: (847) 546-6450
Fax: (847) 546-6760
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Bruce
Phone: (847) 546-6450

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X CA06140005A Illinois
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X

Profile Details

NPI number 1457573099
LBN Legal business name Nicasa
DBA Doing business as
Authorized official Johnson, Bruce
Entity Organization
Organization subpart 1 No
Enumeration date May 3rd, 2007
Last updated Apr 6th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1457573099 NPPES
Illinois MEDICAID CA06140002A
Illinois MEDICAID CA06140005A
Illinois Other A06140005A
Illinois Other A06140004A
Illinois MEDICAID CA06140001A
Illinois Other A06140003A
Illinois Other A06140001A
Illinois Other A06140002A

Popular Providers