| Family Service Agency Of Dekalb County, Inc. | |
|
1325 Sycamore Rd Dekalb IL 60115-2483 | |
| (815) 758-8616 | |
| Not Available |
| Full Name | Family Service Agency Of Dekalb County, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1325 Sycamore Rd, Dekalb, Illinois |
| Authorized Official Name and Position | Tynisha Clegg (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 8157588616 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Service Agency Of Dekalb County, Inc. 1325 Sycamore Rd Dekalb IL 60115-2483 Ph: (815) 758-8616 | Family Service Agency Of Dekalb County, Inc. 1325 Sycamore Rd Dekalb IL 60115-2483 Ph: (815) 758-8616 |
| NPI Number | 1184154007 |
|---|---|
| Provider Enumeration Date | 06/13/2017 |
| Last Update Date | 11/17/2023 |
| Certification Date | 11/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184154007 | NPI | - | NPPES |
| 17004 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 17004 (Illinois) | Primary |
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