DEKALB BEHAVIORAL HEALTH FOUNDATION, INC.


Address: 631 S 1st St, Dekalb, IL 60115
Phone: 8157564875

DEKALB BEHAVIORAL HEALTH FOUNDATION, INC. (NPI# 1659868859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1659868859
Entity Type Organization
Organization Name DEKALB BEHAVIORAL HEALTH FOUNDATION, INC.
Other Organization Name NORTHWESTERN MEDICINE BEN GORDON CENTER
Practice Address 631 S 1st St
Dekalb
IL 60115
Mailing Address Po Box 1109
Dekalb
IL 60115-7109
Practice Telephone 8157564875
Practice Fax Number 8157562944
Mailing Telephone 8157564875
Mailing Fax Number 8157562944
Enumeration Date 2018-04-13
Last Update Date 2018-07-23
Authorized Official Name CHRISTINE ZYDEK (DIRECTOR OF FINANCE)
Authorized Official Telephone 8157482986
Is Organization Subpart Y
Parent Organization Name DEKALB BEHAVIORAL HEALTH FOUNDATION, INC.

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Northwestern Medicine Ben Gordon Center Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1316304058 Dekalb Behavioral Health Foundation, Inc. Clinic/Center 100 S Latham St Ste 204, Sandwich, IL 60548 2016-01-26
1487015194 Dekalb Behavioral Health Foundation, Inc. Clinic/Center 100 S Latham St Ste 204, Dasa, Sandwich, IL 60548 2016-03-09
1437519345 Dekalb Behavioral Health Foundation, Inc. Clinic/Center 12 Health Services Dr, Dasa, Dekalb, IL 60115 2016-03-04
1306203856 Dekalb Behavioral Health Foundation, Inc. Clinic/Center 631 S 1st St, Dekalb, IL 60115 2016-01-27
1255703450 Dekalb Behavioral Health Foundation, Inc. Clinic/Center 12 Health Services Dr, Dekalb, IL 60115 2015-10-27

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities DEKALB BEHAVIORAL HEALTH FOUNDATION, INC. 12 Health Services Drive, Dekalb, IL 60115-9637

Office Location

Street Address 631 S 1ST ST
City DEKALB
State IL
Zip Code 60115

Providers in the same location

NPI Name Taxonomy Address Enumeration
1972788925 Community Support Program/reality House Clinic/Center 631 S 1st St, Dekalb, IL 60115-4117 2008-01-08
1164023719 Amanda Marie Reeves Counselor 631 S 1st St, Dekalb, IL 60115-4117 2020-11-02
1184223141 Kendra Scrutchens Counselor 631 S 1st St, Dekalb, IL 60115-4117 2020-10-21
1073137519 Emily Nicole Taylor Counselor 631 S 1st St, Dekalb, IL 60115-4117 2020-06-01
1871117564 Dawn Magnuson Counselor 631 S 1st St, Dekalb, IL 60115-4117 2020-05-29
1376164822 Jasmine Alexis Sronkoski Social Worker 631 S 1st St, Dekalb, IL 60115-4117 2020-05-06
1831738616 Alissa E Taylor Counselor 631 S 1st St, Dekalb, IL 60115-4117 2019-12-27
1912546995 Melissa Ybarra-robinson Counselor 631 S 1st St, Dekalb, IL 60115-4117 2019-12-23
1144868357 Bethany Ann Johnson Counselor 631 S 1st St, Dekalb, IL 60115-4117 2019-12-18
1407401086 Dominique Marie Smith Counselor 631 S 1st St, Dekalb, IL 60115-4117 2019-08-09
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598372179 Megan Erhart Counselor 304 N. 6th Street, Dekalb, IL 60115 2020-09-28
1689141616 Stephanie Klewin Psychologist 631 S 1st Street, Dekalb, IL 60115 2018-10-29
1164902219 Kimberly Ann Hart Counselor 290 N. Annie Glidden Drive, Gh 416, Niu, Dekalb, IL 60115 2018-08-17
1497235824 Cory David Michael Hayden Specialist/Technologist 175 Yordon Center (niu Athletic Training), Dekalb, IL 60115 2018-08-15
1154807808 Michael John Borak Pharmacist 975 S Annie Glidden Road, Schnucks Market Inc, Dekalb, IL 60115 2018-07-16
1184125841 Candace Schroeffel Student in an Organized Health Care Education/Training Program 520 Garden Rd, Dekalb, IL 60115 2018-02-27
1033627583 Hannah M Studebaker Massage Therapist 3266 Sycamore Road, Dekalb, IL 60115 2018-01-18
1649700238 Jennifer Mangino Behavioral Analyst 138 Berkshire Dr, Dekalb, IL 60115 2017-06-15
1003346628 Victoria Tullock Counselor 631 South First St., Dekalb, IL 60115 2017-06-15
1194263848 Brianna Kraft Specialist/Technologist 900 Crane Dr, Dekalb, IL 60115 2017-02-02
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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1437519345 Dekalb Behavioral Health Foundation, Inc. Clinic/Center 12 Health Services Dr, Dasa, Dekalb, IL 60115 2016-03-04

Providers in the same taxonomy and state

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
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Competitor

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City DEKALB
Zip Code 60115

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Dataset Information

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.

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