NPIMap

Organization Active NPI

Rosecrance Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Chicago, IL
National Provider Identifier
1578082020
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
A-0601-0052-A Issued in IL
Legal business name
ROSECRANCE INC.
Practice address
5440 N Cumberland Ave Ste 165
Chicago, IL 60656-4708
Phone
(815) 391-1000
NPI assigned
Sep 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Authorized official

Name
Lisa Nicole Primm
Title
VP of Payer Relations
Phone
(815) 391-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X A-0601-0052-A IL Primary

Addresses

Primary practice location

5440 N Cumberland Ave Ste 165
Chicago, IL 60656-4708

Mailing address

1021 N Mulford Rd
Rockford, IL 61107-3877
Phone (815) 387-5600

Other identifiers 1

IdentifierTypeStateIssuer
A-0601-0052-AOtherILDASA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130502000371 IL Part B Supplier - Clinic/Group Practice 3779656582 Receives reassigned benefits from 92 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: La Grange, IL; Rockford, IL; McHenry, IL; Moline, IL; Northbrook, IL; Urbana, IL; Warrenville, IL; Chicago, IL…

National Provider Directory

National Provider Directory
Tax ID family
Roscrance 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.

View all 24

Practitioners & affiliated clinicians

Practitioners 3

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": "1505433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1578082020",
    "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": "815-387-5600",
            "fax_number": "815-316-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 N CUMBERLAND AVE STE 165",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606564708",
            "telephone_number": "815-391-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSECRANCE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-15",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "PRIMM",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "VP OF PAYER RELATIONS",
        "authorized_official_telephone_number": "815-391-1000"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "A-0601-0052-A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DASA LICENSE",
            "identifier": "A-0601-0052-A",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.