Rosecrance Inc
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Rockford, IL
NPI 1013289446 · NPPES record last updated May 21, 2013
Key facts
- NPI
- 1013289446
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- ROSECRANCE INC
- Practice address
- 1021 N Mulford Rd
Rockford, IL 61107-3877 - Phone
- (815) 391-1000
- Fax
- (815) 316-4726
- NPI assigned
- Feb 1, 2012
- Organization subpart
- No
Authorized official
- Name
- Mr. Philip W Eaton, CEO
- Title
- President / Ceo
- Phone
- (815) 391-1000
Corporate family (same tax ID) 12
Practitioners 97
-
Mojisola Adedoyin Ayorinde, PMHNP-BC
-
John Steven Cummins, M.D.
-
Crystal Monique Davis, PMHNP-BC
-
Veronica Natalie Flores, LPC, CADC
-
Caroline Golko, LCSW
-
Toya Rhashinda Hodges, LCSW, LSW, CADC
-
Shahina H Jafry, M.D.
-
Alexandra Kane, M.S., L.P.C
-
Robert Laib, LCPC
-
Dominique Loverde, LCSW
-
Endia V McDonald, PMHNP-BC
-
Laura L Meade, PMHNP-BC
-
Joseph M Neubauer, M.D.
-
Muyao Robin, APRN
-
Olivia L Spence, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130502000371 | IL | Part B Supplier - Clinic/Group Practice | 3779656582 |
Receives reassigned benefits from 92 practitioners Practice locations: La Grange, IL; Rockford, IL; McHenry, IL; Moline, IL; Northbrook, IL; Urbana, IL; Warrenville, IL; Chicago, IL… |
National Provider Directory
- Tax ID family
- Roscrance Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes | ||
| Substance Abuse Rehabilitation Facility | 324500000X |
Addresses
Primary practice location
1021 N Mulford Rd
Rockford, IL 61107-3877
Mailing address
1021 N Mulford Rd
Rockford, IL 61107-3877
Phone (815) 391-1000
Other providers in Rockford, IL
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- Rosecrance Inc
- Rosecrance Inc
- Rosecrance Inc
- Rosecrance Inc
- Rosecrance Inc
All providers in Rockford, IL · Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.