Active NPI
Rosecrance Inc
Doing business as Rosecrance RIC
- Substance Use Disorder Rehabilitation Clinic/Center
- Rockford, IL
National Provider Identifier
1699106468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center
- Legal business name
- ROSECRANCE INC
- Doing business as
- Rosecrance RIC
- Practice address
- 526 W State St
Rockford, IL 61101-1214 - Phone
- (815) 391-1000
- Fax
- (815) 316-4726
- NPI assigned
- Dec 4, 2013
- Last updated
- Apr 27, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Phil Eaton
- Title
- Ceo/President
- Phone
- (815) 391-1000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | NU | Primary |
Addresses
Primary practice location
526 W State St
Rockford, IL 61101-1214
Mailing address
1021 N Mulford Rd
Rockford, IL 61107-3877
Phone (815) 391-1000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04081 | Medicaid | IL | |
| A-0601-0045-A | Medicaid | IL |
Other names 1
- Rosecrance RIC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Rosecrance Inc
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.
-
dba Rosecrance Harbor House
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Rockford, IL
- NPI 1588945869
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Rockford, IL
- NPI 1790066082
-
dba Rosecrance Harrison - Outpatient
- Substance Use Disorder Rehabilitation Clinic/Center
- Rockford, IL
- NPI 1568459709
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Kankakee, IL
- NPI 1609576214
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Champaign, IL
- NPI 1629426002
-
- Clinical Psychologist
- Urbana, IL
- NPI 1629868641
-
dba Rosecrance
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Moline, IL
- NPI 1639892698
-
dba Rosecrance Benton Supervised LIving
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Rockford, IL
- NPI 1710268008
-
dba Rosecrance Woodstock House
- Substance Abuse Rehabilitation Facility
- Woodstock, IL
- NPI 1720488604
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Champaign, IL
- NPI 1801244231
-
- Substance Abuse Rehabilitation Facility
- Urbana, IL
- NPI 1811490030
-
- Adolescent and Children Mental Health Clinic/Center
- Rockford, IL
- NPI 1831663798
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386115200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1524787200000",
"number": "1699106468",
"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": "526 W STATE ST",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611011214",
"telephone_number": "815-391-1000",
"fax_number": "815-316-4726"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROSECRANCE INC",
"organizational_subpart": "NO",
"enumeration_date": "2013-12-04",
"last_updated": "2018-04-27",
"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"
},
"taxonomies": [
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04081",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "A-0601-0045-A",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Rosecrance RIC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Rosecrance RIC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.