FOOTPRINTS ELGIN IL LLC (NPI# 1114498813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114498813 |
| Entity Type | Organization |
| Organization Name | FOOTPRINTS ELGIN IL LLC |
| Practice Address |
411 W River Rd Elgin IL 60123-1570 |
| Mailing Address |
Po Box 779101 Chicago IL 60677-9101 |
| Practice Telephone | 2245232581 |
| Mailing Telephone | 8728103540 |
| Mailing Fax Number | 7323606394 |
| Enumeration Date | 2018-12-07 |
| Last Update Date | 2020-05-15 |
| Authorized Official Name | ALEKSANDRA SABANAGIC (DIRECTOR OF REVENUE CYCLE) |
| Authorized Official Telephone | 8728103540 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174200000X | Meals | Other Service Providers | ||
| N | 177F00000X | Lodging | Other Service Providers | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| N | 343900000X | Non-emergency Medical Transport (VAN) | Transportation Services | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Footprints to Recovery | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FOOTPRINTS ELGIN IL LLC | 411 W River Rd, Elgin, IL 60123-1570 |
| Street Address |
411 W RIVER RD |
| City | ELGIN |
| State | IL |
| Zip Code | 60123-1570 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093290124 | Nicholas W. Marchand | Counselor | 411 W River Rd, Elgin, IL 60123-1570 | 2018-09-25 |
| 1831790617 | Patrick Miranda | Counselor | 411 W River Rd, Elgin, IL 60123-1570 | 2020-11-06 |
| 1982201489 | Karen Krucek | Registered Nurse | 411 W River Rd, Elgin, IL 60123-1570 | 2020-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629625736 | Edna Lopez | Social Worker | 1140 N. Mclean Blvd #1, Elgin, IL 60123 | 2019-08-22 |
| 1003472259 | Katelyn Lee O'connell | Counselor | 695 S. Sate Street, Elgin, IL 60123 | 2019-05-14 |
| 1598235152 | Katie Elizabeth Dwyer | Counselor | 695 S. State Street, Elgin, IL 60123 | 2018-11-27 |
| 1174002778 | James M Accetta | Counselor | 52 Surry Drive, Elgin, IL 60123 | 2018-08-14 |
| 1770086175 | Griswold Home Care | Adult Companion | 707 A Davis Road, Suite 203, Elgin, IL 60123 | 2018-03-12 |
| 1003315706 | Danielle Bryant | Nurse Practitioner | 745 Fletcher Dr Ste 101, Elgin, IL 60123 | 2018-02-08 |
| 1912421470 | Deborah Foshager | Counselor | 680 Shenandoah Trail, Elgin, IL 60123 | 2017-07-26 |
| 1760903470 | Miguel Camargo | Specialist/Technologist | 12 N Aldine St, Elgin, IL 60123 | 2017-07-03 |
| 1134658594 | David Sommer | Counselor | 1460 Umbdenstock Rd, Elgin, IL 60123 | 2017-06-08 |
| 1649719618 | Faheem Unisa Syed | Clinical Nurse Specialist | 1990 Larkin Ave., Elgin, IL 60123 | 2017-02-23 |
| Find all providers in zip 60123 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356560320 | Abacus Program | Clinic/Center | 555 Tollgate Rd Ste A, Elgin, IL 60123-9314 | 2007-04-25 |
| 1124644885 | Ecker Center for Behavioral Health | Clinic/Center | 1845 Grandstand Pl, Elgin, IL 60123-6603 | 2020-06-18 |
| 1184249179 | Ecker Center for Behavioral Health | Clinic/Center | 2 American Way, Elgin, IL 60120-4341 | 2020-06-15 |
| 1841414539 | Lutheran Social Services of Illinois | Clinic/Center | 675 Varsity Dr, Elgin, IL 60120-8176 | 2007-04-12 |
| 1679691323 | Renz Addiction Counseling Center | Clinic/Center | 2 American Way, Elgin, IL 60120-4341 | 2007-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689273153 | Navis Health LLC | Clinic/Center | 2602 Rolling Acres Dr, Champaign, IL 61822-7240 | 2020-10-25 |
| 1164036661 | Existential Counselor Societ Ltd. | Clinic/Center | 1225 Richards St, Joliet, IL 60433-2745 | 2020-09-02 |
| 1457964934 | Rosecrance Inc | Clinic/Center | 15 N Galena Ave, Freeport, IL 61032-4348 | 2020-08-25 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1174148167 | Associates In Behavioral Health Care | Clinic/Center | 910 Lake St Ste 102, Roselle, IL 60172-3384 | 2020-06-15 |
| 1538784533 | Associates In Behavioral Health Care | Clinic/Center | 1375 E Schaumburg Rd Ste 120, Schaumburg, IL 60194-3643 | 2020-06-15 |
| 1265056964 | Gateway Foundation, Inc. | Clinic/Center | 3040 Finley Rd, Downers Grove, IL 60515-5713 | 2020-05-29 |
| 1922634021 | Lutheran Social Services of Illinois | Clinic/Center | 400 N Cherry St, Morrison, IL 61270-2605 | 2020-03-20 |
| 1144852260 | Vincent Wallace | Clinic/Center | 226 W Ontario St, Chicago, IL 60654-3619 | 2020-02-06 |
| 1093354037 | A Bridge Back, Inc. | Clinic/Center | 314 Mchenry Rd, Buffalo Grove, IL 60089-2428 | 2019-12-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.