ILLINOIS MEDICAID-SUBSTANCE ABUSE GALESBURG
NPI 1497123509
Clinic/Center - Rehabilitation, Substance Use Disorder in Galesburg, IL
NPI Status: Active since September 04, 2015
Contact Information
2323 WINDISH DR
GALESBURG, IL
ZIP 61401
Phone: (309) 344-4200
Fax: (309) 344-4281
- Organization
- Clinic/Center
- Rehabilitation, Substance Use Disorder
- CLIA Number: 14D0936533
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-01-2027
About ILLINOIS MEDICAID-SUBSTANCE ABUSE GALESBURG
This page provides the complete NPI Profile along with additional information for Illinois Medicaid-substance Abuse Galesburg, a provider established in Galesburg, Illinois operating as a Clinic/center, focusing in rehabilitation, substance use disorder . The healthcare provider is registered in the NPI registry with number 1497123509 assigned on September 2015. The practitioner's primary taxonomy code is 261QR0405X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mr. Bill Arthur Nelson Lcpc (Ceo)
- NPI
- 1497123509
- Provider Name
- ILLINOIS MEDICAID-SUBSTANCE ABUSE GALESBURG
- Entity Type
- Organization
- Location Address
- 2323 WINDISH DR GALESBURG, IL 61401
- Location Phone
- (309) 344-4200
- Location Fax
- (309) 344-4281
- Mailing Address
- 2323 WINDISH DR GALESBURG, IL 61401
- Mailing Phone
- (309) 344-4200
- Mailing Fax
- (309) 344-4281
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 09-04-2015
- Last Update Date
- 08-19-2019
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Rehabilitation, Substance Use Disorder
- Taxonomy Code
- 261QR0405X
- Type
- Ambulatory Health Care Facilities
- License State
- IL
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | A-0118-0005-A (IL) |
| 2 | 261QM2800X | Ambulatory Health Care Facilities | Clinic/Center |
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D0936533
- Facility Type
- Physician Office
- Certificate Effective Date
- January 02, 2025
- Certificate Expiration Date
- January 01, 2027
- Laboratory Director
- WEI LIU
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Illinois Medicaid-substance Abuse Galesburg after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1497123509, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
GALESBURG, IL 61401
GALESBURG, IL 61401
GALESBURG, IL 61401
GALESBURG, IL 61401
GALESBURG, IL 61401
GALESBURG, IL 61401
GALESBURG, IL 61401
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1497123509, enumerated as an "organization" on September 04, 2015.
The provider is located at 2323 WINDISH DR GALESBURG, IL 61401 and the phone number is (309) 344-4200.
Clinic/Center with taxonomy code 261QR0405X and a focus in Rehabilitation, Substance Use Disorder.
