Healthcare Provider Details

I. General information

NPI: 1457959140
Provider Name (Legal Business Name): HOLISTIC HEALTH AND BEHAVIORAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 EXECUTIVE DR STE 339
AURORA IL
60504-8124
US

IV. Provider business mailing address

75 EXECUTIVE DR STE 447
AURORA IL
60504-8112
US

V. Phone/Fax

Practice location:
  • Phone: 773-603-5858
  • Fax: 734-203-7149
Mailing address:
  • Phone: 773-603-5858
  • Fax: 734-203-7149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. LAWRENCE ABAH
Title or Position: OWNER
Credential: NP
Phone: 773-603-5858