=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750276861
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARES COLLABORATIVE NFP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/10/2025
-----------------------------------------------------
Last Update Date | 09/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27W580 WARRENVILLE RD
-----------------------------------------------------
City | WARRENVILLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60555-3903
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-866-3156
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 27W580 WARRENVILLE RD
-----------------------------------------------------
City | WARRENVILLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60555-3903
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-866-3156
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. AMIT THAKER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 630-866-3156
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0855X
-----------------------------------------------------
Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------