Healthcare Provider Details

I. General information

NPI: 1982787693
Provider Name (Legal Business Name): ECKER CENTER FOR BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 GRANDSTAND PLACE
ELGIN IL
60123
US

IV. Provider business mailing address

1845 GRANDSTAND PL
ELGIN IL
60123-6603
US

V. Phone/Fax

Practice location:
  • Phone: 847-695-0484
  • Fax: 847-695-1265
Mailing address:
  • Phone: 847-695-0484
  • 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
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: PAULINE ROCHFORT
Title or Position: BILLING DIRECTOR
Credential:
Phone: 847-695-0484