Organization
ROSECRANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP EATON (CEO / PRESIDENT)
(815) 391-1000
Entity
Organization
Contact information
Practice address
3701 N ASHLAND AVE, CHICAGO, IL 60613-3601
(815) 391-1000
(815) 316-4726
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3877
(815) 391-1000
(815) 316-4726
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
05/28/2015
Last updated
08/11/2022
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