Healthcare Provider Details

I. General information

NPI: 1073743423
Provider Name (Legal Business Name): BHC STREAMWOOD HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 07/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3445 ELMWOOD RD
ROCKFORD IL
61101-9529
US

IV. Provider business mailing address

1400 E IRVING PARK RD
STREAMWOOD IL
60107-3201
US

V. Phone/Fax

Practice location:
  • Phone: 815-877-3440
  • Fax: 815-636-5041
Mailing address:
  • Phone: 630-837-9000
  • Fax: 630-540-4285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number47613710
License Number StateIL

VIII. Authorized Official

Name: MS. NANCY COSTELLO
Title or Position: CFO
Credential:
Phone: 630-837-9000