TABULARASA INTEGRATIVE HEALTH INC NPI 1285384248

NPI Information

  • NPI: 1285384248
  • Provider Name: TABULARASA INTEGRATIVE HEALTH INC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Organization
  • Doing Business As: TRWC
  • Address: 135 N GREENLEAF ST STE 120
    GURNEE, IL
    ZIP 60031
  • Phone: (224) 430-8109

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NPI Details

TABULARASA INTEGRATIVE HEALTH INC is a professional counselor in Gurnee, IL. TABULARASA INTEGRATIVE HEALTH INC NPI is 1285384248. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Trwc.

The provider's business location address is:

135 N GREENLEAF ST STE 120
GURNEE, IL
ZIP 60031-334
Phone: (224) 430-8109

The provider's authorized official is Kim Barkus .
The authorized official title is Partner and has the following contact phone number (224) 430-8109.

The enumeration date for this NPI number is 3/24/2022 and was last updated on 12/3/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)No
2101YP2500XCounselorProfessionalYes
3103K00000XBehavior AnalystNo
4106S00000XBehavior TechnicianNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11285384248MEDICAIDILLINOIS
2342760608001MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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