Healthcare Provider Details

I. General information

NPI: 1447917034
Provider Name (Legal Business Name): LEGACY COUNSELING AND RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2021
Last Update Date: 09/11/2025
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 RATTRAY DR
ALGONQUIN IL
60102-2748
US

IV. Provider business mailing address

651 S SUTTON RD STE 137
STREAMWOOD IL
60107-2366
US

V. Phone/Fax

Practice location:
  • Phone: 224-699-0589
  • Fax:
Mailing address:
  • Phone: 224-699-0589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: ELIZA ADAMS
Title or Position: CLINICAL DIRECTOR
Credential: LCPC
Phone: 224-699-0589