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NORTHERN ILLINOIS RECOVERY LLC NPI 1518428226


NPI Information

NPI: 1518428226
Provider Name: NORTHERN ILLINOIS RECOVERY LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 14D2168323

Address:
620 N STATE ROUTE 31
CRYSTAL LAKE, IL
ZIP 60012
Phone: (484) 432-0113
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NORTHERN ILLINOIS RECOVERY LLC is a substance abuse rehabilitation facility in Crystal Lake, IL. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. NORTHERN ILLINOIS RECOVERY LLC NPI is 1518428226. The provider is registered as an organization entity type.

The provider's business location address is:

620 N STATE ROUTE 31
CRYSTAL LAKE, IL
ZIP 60012-714
Phone: (484) 432-0113

The provider's authorized official is Nick Howell .
The authorized official title is Executive Director and has the following contact phone number (815) 261-3450.

The CLIA number assigned to this NPI record is 14D2168323 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/26/2019 and was last updated on 9/20/2023.


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
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderNo
2324500000XSubstance Abuse Rehabilitation FacilityYes

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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