Footprints Elgin Il LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

FOOTPRINTS ELGIN IL LLC

Practice address

411 W River Rd
Elgin, IL 60123-1570

Phone

(224) 523-2581

NPI assigned

Dec 7, 2018

Last updated

May 15, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Aleksandra Sabanagic

Title

Director of Revenue Cycle

Phone

(872) 810-3540

Specialties & licenses 7

Addresses

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

{
    "created_epoch": "1544140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1114498813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606779101",
            "telephone_number": "872-810-3540",
            "fax_number": "732-360-6394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W RIVER RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601231570",
            "telephone_number": "224-523-2581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTPRINTS ELGIN IL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-07",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "SABANAGIC",
        "authorized_official_first_name": "ALEKSANDRA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "872-810-3540"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Edita Flynn, LCSW
• Wilson Jing Fong, N.P.
• Foot & Ankle Clinics
• Foot First Podiatry Centers, V.P.C.
• Foot First Podiatry II
• Footprints Recovery Chicago LLC
• Footprints Recovery Il LLC
• Amy Elizabeth Ford
• John Francis Ford, D.D.S.
• Jason R Foreman, M.D.

• Substance Use Disorder Rehabilitation Clinic/Center in Elgin, IL
• Providers in Elgin, IL by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.