NORTHWESTERN MEDICINE BEN GORDON CENTER
NPI 1255703450
Clinic/Center - Mental Health (Including Community Mental Health Center) in Dekalb, IL
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
Specialties & Licenses
Other Names 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Northwestern Medicine Ben Gordon Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
30Medicare enrollment records show 30 clinicians reassign Medicare billing to Northwestern Medicine Ben Gordon Center, which bills Medicare for the services they deliver. Of these, 24 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 6
Nearest to this location (20)
See all 30Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, ILFrequently 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.
Is Dekalb Behavioral Health Foundation, Inc. enrolled in Medicare?
Yes. Dekalb Behavioral Health Foundation, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Dekalb Behavioral Health Foundation, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 30 clinicians in 6 Medicare specialties reassign their Medicare billing to Dekalb Behavioral Health Foundation, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (12), Mental Health Counselor (10) and Nurse Practitioner (4). Of these, 24 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
# Northwestern Medicine Ben Gordon Center · NPI 1255703450
Mental Health (Including Community Mental Health Center) organization in Dekalb, Illinois. Organization record, active in the CMS NPPES registry since October 27, 2015.
## Identity
- **NPI:** 1255703450 (Entity type: Organization)
- **Enumerated:** October 27, 2015
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Legal business name:** Dekalb Behavioral Health Foundation, Inc.
- **Organization subpart:** No
- **Authorized official:** Bettyjo Fortune, FINANCIAL ASSESSOR
## Practice location
- **Address:** 12 HEALTH SERVICES DR, Dekalb, IL 60115
- **Phone:** (815) 756-4875
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 30 clinicians in 6 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (12), Mental Health Counselor (10), Nurse Practitioner (4); 24 practice within 10 miles; [full list](https://npiprofile.com/npi/1255703450/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 23, 2018
- **Other identifiers:** Medicaid 1255703450 (IL)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1255703450) · Data from the CMS NPPES public registry.