NORTHWESTERN MEDICINE BEN GORDON CENTER – NPI #1316304058
Clinic/Center

NORTHWESTERN MEDICINE BEN GORDON CENTER is an AHC clinic located in SANDWICH, IL. NPPES has assigned the NPI number 1316304058 to NORTHWESTERN MEDICINE BEN GORDON CENTER on January 26, 2016. 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
1316304058
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
100 S LATHAM ST STE 204
SANDWICH, IL 60548
Phone: (815) 786-7544 Fax:
Mailing address
PO BOX 1109
DEKALB, IL 60115-7109
Phone: (815) 786-7544 Fax:
Organization Subpart
Yes - NORTHWESTERN MEDICINE BEN GORDON CENTER is subpart of another organization.
Authorized Official
CHRISTINE ZYDEK
DIRECTOR OF FINANCE
Phone: (815) 756-1521
Updated
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)		 IL A-5202-0001-A

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.