Organization
ROSECRANCE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP W. EATON (CEO)
(815) 387-5600
Entity
Organization
Contact information
Practice address
701 LEE ST, DES PLAINES, IL 60016-4539
(815) 391-1000
(815) 391-5040
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3877
(815) 387-5600
(815) 316-4726
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
A-0601-0052-A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A-0601-0052-A
IL STATE LICENSE
IL
Enumeration date
09/20/2017
Last updated
04/24/2018
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