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DR. ETHEL ANN BASS PHD, CADC, CODP1
NPI 1629807250
Counselor - Addiction (Substance Use Disorder) in Chicago, IL

Active since July 31, 2024
45 W 111TH ST, CHICAGO, IL 60628(773) 995-1919 Get Directions Write a Review

NPPES record last updated: May 31, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: May 31, 2025, Jul 31, 2024 (2 updates tracked since 2024).

About Dr. Ethel Ann Bass Phd, Cadc, Codp1 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ETHEL ANN BASS PHD, CADC, CODP1 (NPI 1629807250) is an individual addiction (substance use disorder) provider in Chicago, Illinois, licensed in Illinois (24935) and active in the NPI registry since July 2024. She maintains a secondary practice location in Matteson.

NPPES Registry Identity

NPI1629807250
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameDR. ETHEL ANN BASSCredential: PHD, CADC, CODP1
Location Address45 W 111TH STChicago, IL 60628-4200
Mailing Address4747 Lincoln Mall Dr Ste 410Matteson, IL 60443-3821 · (630) 499-6197 · Fax (630) 423-7873
Phone(773) 995-1919
Sole ProprietorYes
Enumeration DateJuly 31, 2024
Last NPPES UpdateMay 31, 20252 updates tracked since enumeration
NPPES CertifiedMay 31, 2025
✔ NPI 1629807250 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in IL · 24935
Also ListedCounselorTaxonomy 101Y00000X · License 24935 (IL)
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 24935 (IL)
45 W 111TH ST, Chicago, IL 60628
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Secondary Practice Location 1

Location 14747 Lincoln Mall Dr Ste 410Matteson, IL 60443-3821 · Phone (630) 499-6197 · Fax (630) 423-7873

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHAKIRA AYANLAJA APN
Nurse Practitioner (Family)
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3195
JUPITER JANELLE JONES FNP
Nurse Practitioner (Family)
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3000
NEW ROSE HEALTHCARE MANAGEMENT LLC
Emergency Medicine
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3000
JOY B WEST MD SC
Obstetrics & Gynecology
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3000
MADHUPA SUD MD SC
Pediatrics
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3460
MRS. BRENDA BEBEN RD
Dietitian, Registered
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3234
TIARA THOMPSON NURSE PRACTITIONER
Nurse Practitioner (Family)
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3000
DR. ALEXANDRA ISA ASROW M.D.
Emergency Medicine
45 W 111TH ST
CHICAGO, IL 60628
Cook County (773) 995-3000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethel Bass's NPI number?

The NPI number for Ethel Bass is 1629807250. It was assigned to this individual provider in the NPPES registry on July 31, 2024.

Where is Ethel Bass located?

Ethel Bass practices at 45 W 111th St, Chicago, IL 60628. The listed phone number is (773) 995-1919.

What is Ethel Bass's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Ethel Bass was last updated on May 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.