Healthcare Provider Details

I. General information

NPI: 1639466915
Provider Name (Legal Business Name): BHC STREAMWOOD HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2011
Last Update Date: 07/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 E IRVING PARK RD
STREAMWOOD IL
60107-3202
US

IV. Provider business mailing address

1360 E IRVING PARK RD
STREAMWOOD IL
60107-3202
US

V. Phone/Fax

Practice location:
  • Phone: 630-736-2740
  • Fax: 630-736-2763
Mailing address:
  • Phone: 630-736-2740
  • Fax: 630-736-2763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number346984
License Number StateIL

VIII. Authorized Official

Name: ROXANE HARCOURT
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 630-483-5578