Healthcare Provider Details

I. General information

NPI: 1558539718
Provider Name (Legal Business Name): FAMILY SERVICE ASSOCIATION OF GREATER ELGIN AREA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 OGDEN AVE
AURORA IL
60504-4273
US

IV. Provider business mailing address

1752 CAPITAL ST STE 100
ELGIN IL
60124-7896
US

V. Phone/Fax

Practice location:
  • Phone: 847-695-3680
  • Fax: 847-695-4552
Mailing address:
  • Phone: 847-695-3680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: AMANDA ERVIN
Title or Position: BILLING SPECIALIST
Credential:
Phone: 847-695-3680