Nicasa
Nicasa is a healthcare organization registered as Substance Use Disorder Rehabilitation Clinic/Center in Round Lake, IL, holding Type 2 (organization) NPI 1457573099 since 2007. The authorized official on file is Bruce Johnson, Coo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1457573099 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Nicasa |
| Practice address | 31979 N FISH LKAE RD, Round Lake, IL, 60073 |
| Phone | 8475466450 |
| Fax | 8475466760 |
| Enumeration date | 2007-05-03 |
| Last updated in NPPES | 2021-04-06 |
Authorized official
| Name | Bruce Johnson |
|---|---|
| Title | Coo |
| Phone | 8475466450 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health Agency | Secondary | CA06140005A | IL |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CA06140002A | Medicaid | IL | — |
| CA06140005A | Medicaid | IL | — |
| A06140005A | Other | IL | STATE OF ILLINOIS |
| A06140004A | Other | IL | STATE OF ILLINOIS |
| CA06140001A | Medicaid | IL | — |
| A06140003A | Other | IL | STATE OF ILLINOIS |
| A06140001A | Other | IL | STATE OF ILLINOIS |
| A06140002A | Other | IL | STATE OF ILLINOIS |
Copy-ready billing details
Provider: Nicasa NPI: 1457573099 Taxonomy: 261QR0405X (Substance Use Disorder Rehabilitation Clinic/Center) Address: 31979 N FISH LKAE RD, Round Lake, IL, 60073
Verify this record
Cross-check NPI 1457573099 against the authoritative CMS record: view Nicasa on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for Nicasa?
What is the NPI number for Nicasa?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2021-04-06.