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ILLINOIS MEDICAID- SUBSTANCE ABUSE KEWANEE
NPI 1386011161
Clinic/Center - Rehabilitation, Substance Use Disorder in Kewanee, IL

Active since August 27, 2015
137 E COLLEGE ST, KEWANEE, IL 61443(309) 852-4331 Get Directions Write a Review

NPPES record last updated: August 19, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 19, 2019, Apr 12, 2018 (2 updates tracked since 2018).

About Illinois Medicaid- Substance Abuse Kewanee NPPES

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

ILLINOIS MEDICAID- SUBSTANCE ABUSE KEWANEE (NPI 1386011161) is a healthcare organization registered as a rehabilitation, substance use disorder in Kewanee, Illinois and active in the NPI registry since August 2015. The organization lists Bill A Nelson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1386011161
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameILLINOIS MEDICAID- SUBSTANCE ABUSE KEWANEE
Location Address137 E COLLEGE STKewanee, IL 61443-3703
Mailing Address137 E College StKewanee, IL 61443-3703 · (309) 852-4331
Phone(309) 852-4331
Organization SubpartYesParent: Bridgeway Inc
Authorized OfficialBill A NelsonCeo · (309) 344-4200
Enumeration DateAugust 27, 2015
Last NPPES UpdateAugust 19, 20192 updates tracked since enumeration
✔ NPI 1386011161 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License A-0118-0003-A (IL)
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X
Also ListedPsychiatry & Neurology · Child & Adolescent PsychiatryTaxonomy 2084P0804X
Also ListedClinic/Center · MethadoneTaxonomy 261QM2800X
137 E COLLEGE ST, Kewanee, IL 61443
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 9

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

KATHLEEN ANN LINDQUIST LPN
Licensed Practical Nurse
137 E COLLEGE ST
KEWANEE, IL 61443
Henry County (309) 852-4331
DARYLNN JEAN PEART MS LPHA
Counselor (Mental Health)
137 E COLLEGE ST
KEWANEE, IL 61443
Henry County (309) 854-0122
MRS. ELAINE A HUMPHREY LCPC
Counselor (Professional)
137 E COLLEGE ST
KEWANEE, IL 61443
Henry County (309) 852-4331
LISA KAY STEVENS-BUCK CADC
Counselor (Addiction (Substance Use Disorder))
137 E COLLEGE ST
KEWANEE, IL 61443
Henry County (309) 852-4331
DR. REBEKAH FRANCES DEES-MCMAHON D. MIN..
Counselor (Professional)
137 E COLLEGE ST
KEWANEE, IL 61443
Henry County (309) 852-4331
CAROL PERVA RN
Registered Nurse
137 E COLLEGE ST
KEWANEE, IL 61443
Henry County (309) 852-4331
KATHLEEN MORSE LPC
Counselor (Mental Health)
137 E COLLEGE ST
KEWANEE, IL 61443
Henry County (309) 852-4331
BRIDGEWAY INC
Clinic/Center (Mental Health (Including Community Mental Health Center))
137 E COLLEGE ST
KEWANEE, IL 61443
Henry County (309) 852-4331

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 Illinois Medicaid- Substance Abuse Kewanee's NPI number?

The NPI number for Illinois Medicaid- Substance Abuse Kewanee is 1386011161. It was assigned to this organization in the NPPES registry on August 27, 2015.

Where is Illinois Medicaid- Substance Abuse Kewanee located?

Illinois Medicaid- Substance Abuse Kewanee is located at 137 E College St, Kewanee, IL 61443. The listed phone number is (309) 852-4331.

What is Illinois Medicaid- Substance Abuse Kewanee's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

When was this NPI record last updated?

The NPPES record for Illinois Medicaid- Substance Abuse Kewanee was last updated on August 19, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.