| Rosecrance Crystal Lake | |
|
422 Tracy Court Crystal Lake IL 60014 | |
| (815) 391-1000 | |
| (815) 316-4726 |
| Full Name | Rosecrance Crystal Lake |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 422 Tracy Court, Crystal Lake, Illinois |
| Authorized Official Name and Position | Phil Eaton (CEO / PRESIDENT) |
| Authorized Official Contact | 8153911000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosecrance Crystal Lake 1021 N Mulford Rd Rockford IL 61107-3877 Ph: (815) 391-1000 | Rosecrance Crystal Lake 422 Tracy Court Crystal Lake IL 60014 Ph: (815) 391-1000 |
| NPI Number | 1124449731 |
|---|---|
| Provider Enumeration Date | 12/27/2013 |
| Last Update Date | 09/05/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124449731 | NPI | - | NPPES |
| A-0601-0036-A | Medicaid | IL | |
| 04081 | Medicaid | IL |
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