Provider Demographics
NPI:1407285638
Name:SPECIALIZED ASSESSING SYSTEMS INSTITUTE, CORP
Entity Type:Organization
Organization Name:SPECIALIZED ASSESSING SYSTEMS INSTITUTE, CORP
Other - Org Name:SASI, ELWOOD P NYTHER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ELWOOD
Authorized Official - Middle Name:P
Authorized Official - Last Name:NYTHER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-818-9607
Mailing Address - Street 1:8251 S RHODES AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-5005
Mailing Address - Country:US
Mailing Address - Phone:773-818-9607
Mailing Address - Fax:
Practice Address - Street 1:8251 S RHODES AVE
Practice Address - Street 2:4500 S MICHIGAN
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-5005
Practice Address - Country:US
Practice Address - Phone:773-818-9607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149004694101YA0400X, 101YM0800X, 101YP2500X, 251S00000X
IL101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1477561116OtherPTAN# IL7750