Rosecrance Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ROSECRANCE INC

Doing business as

Rosecrance Crystal Lake

Practice address

422 Tracy Court
Crystal Lake, IL 60014

Phone

(815) 391-1000

Fax

(815) 316-4726

NPI assigned

Dec 27, 2013

Last updated

Sep 5, 2018By 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

Phil Eaton, MBA

Title

Ceo / President

Phone

(815) 391-1000

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Rosecrance Crystal Lake Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Tax ID family

Rosecrance Inc97 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Roscrance Inc.

  dba Rosecrance Griffin Willaimson

  • Substance Abuse Rehabilitation Facility
  • Rockford, IL
  • NPI 1174051031
  NPD tax ID
• Rosecrance

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Chicago, IL
  • NPI 1063891646
  NPD tax ID
• Rosecrance

  • Primary Care Clinic/Center
  • Rockford, IL
  • NPI 1164174140
  NPD tax ID
• Rosecrance Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rockford, IL
  • NPI 1013289446
  NPD tax ID
• Rosecrance Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Urbana, IL
  • NPI 1013364454
  NPD tax ID
• Rosecrance Inc

  dba Rosecrance

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Freeport, IL
  • NPI 1023764693
  NPD tax ID
• Rosecrance Inc

  • Substance Abuse Rehabilitation Facility
  • Champaign, IL
  • NPI 1043774037
  NPD tax ID
• Rosecrance Inc

  • Substance Abuse Rehabilitation Facility
  • La Grange, IL
  • NPI 1053762344
  NPD tax ID
• Rosecrance Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Champaign, IL
  • NPI 1083061469
  NPD tax ID
• Rosecrance Inc

  dba Rosecrance Dakota Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Crystal Lake, IL
  • NPI 1134575558
  NPD tax ID
• Rosecrance Inc

  dba Rosecrance McHenry County

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • McHenry, IL
  • NPI 1144585803
  NPD tax ID
• Rosecrance Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kankakee, IL
  • NPI 1194425702
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shannon Marie Ferriter

  • Counselor
  • Rockford, IL
  • NPI 1417435652
  NPD

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

{
    "created_epoch": "1388102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536105600000",
    "number": "1124449731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073877",
            "telephone_number": "815-391-1000",
            "fax_number": "815-316-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 TRACY COURT",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "815-391-1000",
            "fax_number": "815-316-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSECRANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-27",
        "last_updated": "2018-09-05",
        "status": "A",
        "authorized_official_last_name": "EATON",
        "authorized_official_first_name": "PHIL",
        "authorized_official_title_or_position": "CEO / PRESIDENT",
        "authorized_official_telephone_number": "815-391-1000",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04081",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A-0601-0036-A",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rosecrance Crystal Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rosecrance Crystal Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zitlalli Z Roman Rodriguez, LCSW
• Jorge Roman
• Jennee A Rommel, M.D.
• Margarete A. Ronnett, PSY.D.
• Matilda M Rosanwo, MD
• Rosecrance Inc (Rosecrance Dakota Clinic)
• Rosecrance, Inc. (Roscrance Crystal Lake)
• Allison Roseland, PT, DPT
• Ria Rosier, PT, DPT
• Jasmine Ross, BCBA

• Mental Health Clinic/Center (Including Community Mental Health Center) in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.