NPIMap

Organization Active NPI

Breaking Free

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Aurora, IL
National Provider Identifier
1295872513
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
BREAKING FREE
Practice address
120 Gale St
Suite 200
Aurora, IL 60506-5084
Phone
(630) 897-1003
Fax
(630) 572-0566
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Authorized official

Name
Mr. Herbert Stricklin, M.S., LCPC
Title
Director of Clinical Operations
Phone
(630) 897-1003

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X A-0380-0002-A IL
Community/Behavioral Health Agency 251S00000X IL
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

120 Gale St
Suite 200
Aurora, IL 60506-5084

Mailing address

120 Gale St
Aurora, IL 60506-5084
Phone (308) 971-0036

Other identifiers 2

IdentifierTypeStateIssuer
1839OtherILBLUE CROSS PROVIDER NUMBE
0380OtherILDASA PROVIDER NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Breaking Free Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

120 Gale St
Ste 200
Aurora, IL 60506
Phone (630) 897-1003

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": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1295872513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 GALE ST",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605065084",
            "telephone_number": "308-971-0036",
            "fax_number": "308-971-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 GALE ST",
            "address_2": "SUITE 200",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605065084",
            "telephone_number": "630-897-1003",
            "fax_number": "630-572-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKING FREE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "STRICKLIN",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "630-897-1003",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S., LCPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "A-0380-0002-A",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "1839",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DASA PROVIDER NUMBER",
            "identifier": "0380",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.