Provider Demographics
NPI:1598256299
Name:CARDINAL AUTISM SERVICES LLC
Entity Type:Organization
Organization Name:CARDINAL AUTISM SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-972-1824
Mailing Address - Street 1:7360 N LINCOLN AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1705
Mailing Address - Country:US
Mailing Address - Phone:847-972-1824
Mailing Address - Fax:855-855-2712
Practice Address - Street 1:501 S STATE ROAD 7 STE 106
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-4044
Practice Address - Country:US
Practice Address - Phone:855-855-2712
Practice Address - Fax:855-855-2712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty