Duane Dean Behavioral Health Center

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

DUANE DEAN BEHAVIORAL HEALTH CENTER

Practice address

1113 E Court St
Kankakee, IL 60901-4256

Phone

(815) 939-0125

Fax

(815) 929-1651

NPI assigned

Oct 6, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Eddy Fernando Borrayo

Title

President/Ceo

Phone

(773) 564-9070

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Duane Dean Behavioral Health Center

  • Methadone Clinic
  • Kankakee, IL
  • NPI 1043345119

  7315377454

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Duane Dean Behavioral Health Center3 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.

• Ddbhc Family Centered Treatment and Recovery Support Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Kankakee, IL
  • NPI 1942688973
  NPD tax ID
• Duane Dean Behavioral Health Center

  • Methadone Clinic
  • Kankakee, IL
  • NPI 1043345119
  NPD tax ID

Locations

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1982366027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3942 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474639",
            "telephone_number": "773-564-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 E COURT ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609014256",
            "telephone_number": "815-939-0125",
            "fax_number": "815-929-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUANE DEAN BEHAVIORAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-06",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "BORRAYO",
        "authorized_official_first_name": "EDDY",
        "authorized_official_middle_name": "FERNANDO",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "773-564-9070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominik Dubravec DDS MMSC PC
• Donald E Krause DDS LTD
• Andrew J Donofrio, PA-C
• Dr. Simone & Associates
• Duane Dean Behavioral Health Center
• Dominik B Dubravec, DDS, MMSC
• Suresh Duvvada, MD
• Sunny Eartly, OTR/L
• Adnan Ebrahim, PHARM. D
• Daniela Echeverri Idrobo

• Clinical Medical Laboratory in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.