1982090304 NPI number — A.B.S. BEHAVIORAL SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982090304 NPI number — A.B.S. BEHAVIORAL SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A.B.S. BEHAVIORAL SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982090304
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/29/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5471 RIVER PARK DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIBERTYVILLE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60048
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-880-8002
Provider Business Mailing Address Fax Number:
773-666-5883

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8707 SKOKIE BLVD
Provider Second Line Business Practice Location Address:
SUITE 402
Provider Business Practice Location Address City Name:
SKOKIE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60077
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-344-9205
Provider Business Practice Location Address Fax Number:
773-304-3737
Provider Enumeration Date:
04/13/2015

Additional Information

Authorized Official

Authorized Official Last Name:
HIVELY
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
770-880-8002

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X , with the licence number:  1052372 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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