Provider Demographics
NPI:1932251766
Name:FAMILIES AND ADOLESCENTS IN RECOVERY, INC. FAIR
Entity type:Organization
Organization Name:FAMILIES AND ADOLESCENTS IN RECOVERY, INC. FAIR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:MAGDALENA
Authorized Official - Last Name:MCGUINNESS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, CADC
Authorized Official - Phone:847-359-5192
Mailing Address - Street 1:1834 WALDEN OFFICE SQ
Mailing Address - Street 2:SUITE # 450
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4292
Mailing Address - Country:US
Mailing Address - Phone:847-359-5192
Mailing Address - Fax:847-701-0350
Practice Address - Street 1:1834 WALDEN OFFICE SQ STE 450
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4292
Practice Address - Country:US
Practice Address - Phone:847-359-5192
Practice Address - Fax:847-701-0350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 1041C0700X, 273R00000X
ILA-4341-0002-A276400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1838OtherBLUE CROSS BLUE SHIELD