NORTHWESTERN MEDICINE BEN GORDON CENTER – NPI #1255703450
Clinic/Center

NORTHWESTERN MEDICINE BEN GORDON CENTER is an AHC clinic located in DEKALB, IL. NPPES has assigned the NPI number 1255703450 to NORTHWESTERN MEDICINE BEN GORDON CENTER on October 27, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “NORTHWESTERN MEDICINE BEN GORDON CENTER” is a dba name, the actual legal business name for this organization is DEKALB BEHAVIORAL HEALTH FOUNDATION, INC.. The primary taxonomy selected by this provider is 261QM0801X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Mental Health (Including Community Mental Health Center)

The NPI profile was previously updated about 8 years ago on Jul 23, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for NORTHWESTERN MEDICINE BEN GORDON CENTER below.

NPI Profile for
DEKALB BEHAVIORAL HEALTH FOUNDATION, INC.

NPI Number
1255703450
Enumeration Date

(more than 10 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
DEKALB BEHAVIORAL HEALTH FOUNDATION, INC.
Doing Business As (dba): NORTHWESTERN MEDICINE BEN GORDON CENTER
Primary location
12 HEALTH SERVICES DR
DEKALB, IL 60115
Phone: (815) 756-4875 Fax:
Mailing address
PO BOX 1109
DEKALB, IL 60115-7109
Phone: (815) 756-4875 Fax:
Organization Subpart
No
Authorized Official
BETTYJO FORTUNE
FINANCIAL ASSESSOR
Phone: (815) 756-4875
Updated
Identifiers

Identifiers for NORTHWESTERN MEDICINE BEN GORDON CENTER

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDIL1255703450
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM0801X
- Clinic/Center / Mental Health (Including Community Mental Health Center) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.