Organization Active NPI

Eating Recovery Center

  • Mental Illness Community Based Residential Treatment Facility
  • Chicago, IL
National Provider Identifier
1659814192
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
201543752 Issued in IL
Legal business name
EATING RECOVERY CENTER
Practice address
150 E Huron St
Suite 1200
Chicago, IL 60611-2999
Phone
(312) 964-4617
NPI assigned
Dec 1, 2016
Last updated
Dec 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Authorized official

Name
Mrs. Colleen Mary Watson, LCPCNPI 1760992622
Title
Primary Therapist II
Phone
(312) 964-4617

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 201543752 IL Primary

Addresses

Primary practice location

150 E Huron St
Suite 1200
Chicago, IL 60611-2999

Mailing address

2300 N Lincoln Park W
Unit 1212
Chicago, IL 60614-3456
Phone (630) 649-8772

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
14D2104012Eating Recovery Center of Chicago150 E Huron St, 1200-1300, Chicago, IL 60611Certificate of waiverOct 25, 2027

National Provider Directory

National Provider Directory

Locations

150 E Huron St
Ste 1200
Chicago, IL 60611
Phone (312) 280-0890

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1480550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1659814192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N LINCOLN PARK W",
            "address_2": "UNIT 1212",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143456",
            "telephone_number": "630-649-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E HURON ST",
            "address_2": "SUITE 1200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112999",
            "telephone_number": "312-964-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EATING RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-01",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "PRIMARY THERAPIST II",
        "authorized_official_telephone_number": "312-964-4617",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "IL",
            "license": "201543752",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.