OrganizationActive
Nicasa
NPI 1457573099 · Substance Use Disorder Rehabilitation Clinic/Center · Round Lake, IL
Provider details
- NPI number
- 1457573099
- Entity type
- Organization
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Bruce Johnson, Coo(847) 546-6450
- License
- CA06140005A (IL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Agencies
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
31979 N Fish Lkae Rd
Round Lake, IL 60073
Phone: (847) 546-6450
Fax: (847) 546-6760
Street-level locationGet directions
Mailing address
31979 N Fish Lkae Rd
Round Lake, IL 60073
Registry dates
- Enumerated
- 2007-05-03
- Last updated
- 2021-04-06
- Certified
- 2021-04-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.