NPIMap

Organization Active NPI

Optum Behavioral Care Therapy Services of Illinois PC

  • Clinical Social Worker
  • Rockford, IL
National Provider Identifier
1780579797
Registry record updated Feb 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
OPTUM BEHAVIORAL CARE THERAPY SERVICES OF ILLINOIS PC
Practice address
6392 Linden Rd
Rockford, IL 61109-2816
Phone
(877) 622-0013
NPI assigned
Jun 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2026

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

Authorized official

Name
Stacy Cloyd
Title
Secretary
Phone
(785) 493-5250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

6392 Linden Rd
Rockford, IL 61109-2816

Mailing address

1 Optum Cir
Eden Prairie, MN 55344-2956

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250319003644 IL Part B Supplier - Clinic/Group Practice 2163944190 Receives reassigned benefits from 24 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chicago, IL; Evanston, IL; Rockford, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Optum Behavioral Care Therapy Services of Illinois PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

820 Davis St
Ste 222
Evanston, IL 60201
Phone (379) 668-0060

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1749513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771113600000",
    "number": "1780579797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OPTUM CIR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553442956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6392 LINDEN RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611092816",
            "telephone_number": "877-622-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM BEHAVIORAL CARE THERAPY SERVICES OF ILLINOIS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-10",
        "last_updated": "2026-02-15",
        "certification_date": "2026-02-15",
        "status": "A",
        "authorized_official_last_name": "CLOYD",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "785-493-5250"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 15, 2026; 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.