Rosecrance Dakota Clinic

LBN: Rosecrance Inc
Rosecrance Dakota Clinic is an health care organization with primary practice located at 620 Dakota St , Crystal Lake IL 60012. The organization recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as the primary health care specialty. Rosecrance Inc can be contacted via phone (815) 391-1000, or through Eaton, Phil via phone (815) 391-1000.

Contact Information

Primary practice address
620 Dakota St Crystal Lake IL 60012
Phone: (815) 391-1000
Fax: (815) 316-4726
Website:
Map and Directions
Authorized official contact:
Name: Eaton, Phil
Phone: (815) 391-1000

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1134575558
LBN Legal business name Rosecrance Inc
DBA Doing business as Rosecrance Dakota Clinic
Authorized official Eaton, Phil
Entity Organization
Organization subpart 1 No
Enumeration date May 5th, 2016
Last updated Sep 5th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134575558 NPPES
Illinois MEDICAID 04081

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