Healthcare Provider Details

I. General information

NPI: 1720370489
Provider Name (Legal Business Name): ADAPT OF ILLINOIS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2011
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 N 9TH ST
BELLEVILLE IL
62220-1150
US

IV. Provider business mailing address

2600 WEST BLVD
BELLEVILLE IL
62221-5605
US

V. Phone/Fax

Practice location:
  • Phone: 877-553-9440
  • Fax: 618-235-2493
Mailing address:
  • Phone: 877-553-9440
  • Fax: 618-235-2493

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
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA JANICAK
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 877-553-9440