Organization Active NPI

Duane Dean Behavioral Health Center

  • Methadone Clinic
  • Kankakee, IL
National Provider Identifier
1043345119
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
DUANE DEAN BEHAVIORAL HEALTH CENTER
Practice address
700 E Court St
Kankakee, IL 60901-4131
Phone
(815) 939-0125
Fax
(815) 939-1249
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Eddy Borrayo
Title
President/Ceo
Phone
(773) 564-9070

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X IL

Addresses

Primary practice location

700 E Court St
Kankakee, IL 60901-4131

Mailing address

700 E Court St
Kankakee, IL 60901-4131
Phone (815) 939-0125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Opioid treatment program
Medicare-enrolled since Sep 25, 2025

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200414000879 IL Part B Supplier - Opioid Treatment Program (Otp) 7315377454 Practice locations: Kankakee, IL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2327863Duane Dean Behavioral Health700 E Court Street, Kankakee, IL 60901Certificate of waiverJul 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Duane Dean Behavioral Health Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1043345119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E COURT ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609014131",
            "telephone_number": "815-939-0125",
            "fax_number": "815-939-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E COURT ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609014131",
            "telephone_number": "815-939-0125",
            "fax_number": "815-939-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUANE DEAN BEHAVIORAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "BORRAYO",
        "authorized_official_first_name": "EDDY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "773-564-9070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.