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NORTHWESTERN MEDICINE BEN GORDON CENTER
NPI 1255703450
Clinic/Center - Mental Health (Including Community Mental Health Center) in Dekalb, IL

Active since October 27, 2015CLIA 14D2094651 · Waiver
12 HEALTH SERVICES DR, DEKALB, IL 60115(815) 756-4875 Get Directions Write a Review

NPPES record last updated: July 23, 2018. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Jul 23, 2018, Apr 17, 2018 (2 updates tracked since 2018).

About Northwestern Medicine Ben Gordon Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHWESTERN MEDICINE BEN GORDON CENTER (NPI 1255703450) is a healthcare organization registered as a mental health (including community mental health center) in Dekalb, Illinois and active in the NPI registry since October 2015. The organization holds a CLIA Waiver certificate valid through April 20, 2027 and lists Bettyjo Fortune, Financial Assessor, as its authorized official.

NPPES Registry Identity

NPI1255703450
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameDEKALB BEHAVIORAL HEALTH FOUNDATION, INC.
Location Address12 HEALTH SERVICES DRDekalb, IL 60115
Mailing AddressPo Box 1109Dekalb, IL 60115-7109 · (815) 756-4875
Phone(815) 756-4875
Organization SubpartNo
Authorized OfficialBettyjo FortuneFinancial Assessor · (815) 756-4875
Enumeration DateOctober 27, 2015
Last NPPES UpdateJuly 23, 20182 updates tracked since enumeration
✔ NPI 1255703450 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
12 HEALTH SERVICES DR, Dekalb, IL 60115
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Other Names 1

Doing Business AsNorthwestern Medicine Ben Gordon Center

Other Identifiers 1

Medicaid1255703450IL

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2094651

Dekalb Behavioral Health Foundation Inc Northwestern Medicine Ben Gordon Center · Dekalb, IL
Active · expires Apr 20, 2027
CLIA Number14D2094651
Laboratory TypeCommty Mental Health Ctr
Certificate Effective DateApril 21, 2025
Certificate Expiration DateApril 20, 2027
Laboratory DirectorStepheni M. Osullivan
Laboratory Phone(815) 756-4875
Laboratory LocationDekalb Behavioral Health Foundation Inc Northwestern Medicine Ben Gordon Center12 Health Services Drive, Dekalb, IL 60115
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER L WEBER LSW, CADC
Social Worker (Clinical)
12 HEALTH SERVICES DR
DEKALB, IL 60115
Dekalb County (815) 756-4875
CHRISTI JOHNSON B.S., M.H.P.
Counselor (Mental Health)
12 HEALTH SERVICES DR
DEKALB, IL 60115
Dekalb County (815) 756-4875
CHRISTINE ALEXANDRA ESPE MAXWELL MSED, LCPC, NCC
Counselor
12 HEALTH SERVICES DR
DEKALB, IL 60115
Dekalb County (815) 756-4875
TATJANA N WILLIAMS LSW
Social Worker
12 HEALTH SERVICES DR
DEKALB, IL 60115
Dekalb County (815) 756-4875
JASMINE YOUNG
Counselor (Mental Health)
12 HEALTH SERVICES DR
DEKALB, IL 60115
Dekalb County (815) 756-4875
CASSIE DODD
Counselor (Mental Health)
12 HEALTH SERVICES DR
DEKALB, IL 60115
Dekalb County (815) 756-4875
REBECCA LEACH
Social Worker
12 HEALTH SERVICES DR
DEKALB, IL 60115
Dekalb County (815) 756-4875
VALERIE PENA-HERNANDEZ
Social Worker
12 HEALTH SERVICES DR
DEKALB, IL 60115
Dekalb County (815) 756-4875

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dekalb Behavioral Health Foundation, Inc.'s NPI number?

The NPI number for Dekalb Behavioral Health Foundation, Inc. is 1255703450. It was assigned to this organization in the NPPES registry on October 27, 2015. The provider is doing business as Northwestern Medicine Ben Gordon Center.

Where is Dekalb Behavioral Health Foundation, Inc. located?

Dekalb Behavioral Health Foundation, Inc. is located at 12 Health Services Dr, Dekalb, IL 60115. The listed phone number is (815) 756-4875.

What is Dekalb Behavioral Health Foundation, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Does Dekalb Behavioral Health Foundation, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2094651) is associated with this NPI, valid through April 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dekalb Behavioral Health Foundation, Inc. was last updated on July 23, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.