MEDICARE: STEINBERG BEHAVIOR SOLUTIONS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1598987711	OTHER		TYPE 1 NPI

General Provider Information

NPI Number	:	1174898811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEINBERG BEHAVIOR SOLUTIONS, INC.

Provider Business Mailing Address
First Line	:	6719 N SACRAMENTO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-4222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6719 N SACRAMENTO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-4222
Country	:	US
Telephone Number	:	773-330-1200
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. SARAH R STEINBERG
Credential	:	MS, BCBA
Telephone Number	:	773-330-1200

Provider Enumeration Date	:	03/13/2012
Last Update Date	:	03/13/2012

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