NPIMap

Organization Active NPI

Centerstone of Illinois, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Marion, IL
National Provider Identifier
1982269601
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
CENTERSTONE OF ILLINOIS, INC
Practice address
202 S Bentley St
Marion, IL 62959
Phone
(855) 608-3560
Fax
(618) 997-0489
NPI assigned
May 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Authorized official

Name
Stacy D Phillips
Title
Director of Revenue Cycles
Phone
(618) 937-6483

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Methadone Clinic 261QM2800X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

202 S Bentley St
Marion, IL 62959

Mailing address

902 W Main St
West Frankfort, IL 62896-2210
Phone (618) 937-6483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Opioid treatment program
Medicare-enrolled since Jan 8, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200504000053 IL Part B Supplier - Opioid Treatment Program (Otp) 2961545173 1 other NPI on this enrollment
Practice locations: Marion, IL; Alton, IL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Franklin-Williamson Hum62 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

202 S Bentley St
Marion, IL 62959
Phone (618) 997-5336

NPI Registry JSON

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752451200000",
    "number": "1982269601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W MAIN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962210",
            "telephone_number": "618-937-6483",
            "fax_number": "618-937-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S BENTLEY ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "62959",
            "telephone_number": "855-608-3560",
            "fax_number": "618-997-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERSTONE OF ILLINOIS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-08",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLES",
        "authorized_official_telephone_number": "618-937-6483"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.