RECOVERY CONCEPTS URBANA, LLC (NPI# 1922617133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922617133 |
| Entity Type | Organization |
| Organization Name | RECOVERY CONCEPTS URBANA, LLC |
| Practice Address |
710 W. Killarney St. Urbana IL 61801 |
| Mailing Address |
12489 Josephs Rd Folsom LA 70437-5829 |
| Practice Telephone | 9857053263 |
| Mailing Telephone | 9857053263 |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2020-08-05 |
| Authorized Official Name | DR. RICHARD MANKINEN (DIRECTOR) |
| Authorized Official Telephone | 7083351155 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | RECOVERY CONCEPTS HOLDINGS, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | SUPR ILLINOIS | A-3516-0001-A | 01 |
| Street Address |
710 W. KILLARNEY ST. |
| City | URBANA |
| State | IL |
| Zip Code | 61801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
| 1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
| 1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
| 1710437470 | Fnu Shakuntulla | Internal Medicine | 1400 W Park St, Urbana, Urbana, IL 61801 | 2016-10-06 |
| Find all providers in zip 61801 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862457 | Jem Treatment, Inc | Clinic/Center | 2424 Washington St Ste Ll-110, Waukegan, IL 60085-5074 | 2020-02-05 |
| 1124659123 | Lake County Center, LLC | Clinic/Center | 310 S Greenleaf St Ste 206207, Gurnee, IL 60031-5708 | 2020-01-29 |
| 1750883286 | Buena Vista Group, LLC | Clinic/Center | 418 Dixie Hwy, Chicago Heights, IL 60411-1739 | 2018-02-28 |
| 1518485960 | The Bobby Buonauro Clinic | Clinic/Center | 1029 Howard St Ste 303, Evanston, IL 60202-3877 | 2017-09-06 |
| 1689196578 | Serenity Treatment and Counseling Center Inc | Clinic/Center | 19408 North Creek Drive, Lynwood, IL 60411-8649 | 2017-07-12 |
| 1699296129 | Loren 'half' Robinson Foundation | Clinic/Center | 4100 W Ogden Ave, Chicago, IL 60623-2821 | 2017-07-06 |
| 1942744453 | Recovery Concepts LLC | Clinic/Center | 17100 Dixie Hwy, Suite D & E, Hazel Crest, IL 60429-1485 | 2016-12-19 |
| 1184022303 | Renewed Hope Community Services Inc. | Clinic/Center | 626 E 71st St, Chicago, IL 60619-1212 | 2014-12-22 |
| 1316296007 | Sundance Methadone Treatment Center,llc | Clinic/Center | 4545 N Broadway St, 3rd Floor, Chicago, IL 60640-5975 | 2012-09-10 |
| 1790030344 | Ijegba Community Inc | Clinic/Center | 1950 E 75th St, Chicago, IL 60649-3633 | 2012-07-19 |
| 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.