Healthcare Provider Details

I. General information

NPI: 1801975586
Provider Name (Legal Business Name): FOCUSED THERAPIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 09/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 W MORELAND AVE 11 A - C
ADDISON IL
60101-3867
US

IV. Provider business mailing address

96 W MORELAND AVE 11 A - C
ADDISON IL
60101-3867
US

V. Phone/Fax

Practice location:
  • Phone: 630-543-8400
  • Fax: 630-543-8400
Mailing address:
  • Phone: 630-543-8400
  • Fax: 630-543-8400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number16650
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number72256
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number180-005922
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1635745
Identifier TypeOTHER
Identifier StateIL
Identifier IssuerBLUE CROSS BLUE SHIELD
# 2
Identifier304341 376533
Identifier TypeOTHER
Identifier StateIL
Identifier IssuerTRI CARE
# 3
Identifier30441341
Identifier TypeOTHER
Identifier StateIL
Identifier IssuerMHN
# 4
Identifier11640159
Identifier TypeOTHER
Identifier StateIL
Identifier IssuerCAQH
# 5
Identifier79177885
Identifier TypeOTHER
Identifier StateIL
Identifier IssuerAETNA

VIII. Authorized Official

Name: CAROL MARY SITOWSKI
Title or Position: DIRECTOR
Credential: LCPC, NCC, CADC
Phone: 630-543-8400