ILLINOIS MEDICAID- SUBSTANCE ABUSE KEWANEE NPI 1386011161

NPI Information

NPI: 1386011161
Provider Name: ILLINOIS MEDICAID- SUBSTANCE ABUSE KEWANEE
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
137 E COLLEGE ST
KEWANEE, IL
ZIP 61443
Phone: (309) 852-4331
Get Directions

ILLINOIS MEDICAID- SUBSTANCE ABUSE KEWANEE is a rehabilitation and substance use disorder clinic center in Kewanee, IL. ILLINOIS MEDICAID- SUBSTANCE ABUSE KEWANEE NPI is 1386011161. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

137 E COLLEGE ST
KEWANEE, IL
ZIP 61443-703
Phone: (309) 852-4331

The provider's authorized official is Bill A Nelson .
The authorized official title is Ceo and has the following contact phone number (309) 344-4200.

The enumeration date for this NPI number is 8/27/2015 and was last updated on 8/19/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	A-0118-0003-A	ILLINOIS	No
2	2084P0800X	Psychiatry & Neurology	Psychiatry		ILLINOIS	No
3	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry		ILLINOIS	No
4	261QM2800X	Clinic/Center	Methadone		ILLINOIS	No
5	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder		ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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