Rosecrance Dakota Clinic | |
620 Dakota St Crystal Lake IL 60012 | |
(815) 391-1000 | |
(815) 316-4726 |
Full Name | Rosecrance Dakota Clinic |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 620 Dakota St, 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 Dakota Clinic 1021 N Mulford Rd Rockford IL 61107-3877 Ph: (815) 391-1000 | Rosecrance Dakota Clinic 620 Dakota St Crystal Lake IL 60012 Ph: (815) 391-1000 |
NPI Number | 1134575558 |
---|---|
Provider Enumeration Date | 05/05/2016 |
Last Update Date | 09/05/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134575558 | NPI | - | NPPES |
04081 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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