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ILLINOIS MEDICAID-SUBSTANCE ABUSE MACOMB
NPI 1588032460
Clinic/Center - Rehabilitation, Substance Use Disorder in Macomb, IL

Active since September 09, 2015
900 S DEER RD, MACOMB, IL 61455(309) 837-4876 Get Directions Write a Review

NPPES record last updated: August 19, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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

About Illinois Medicaid-substance Abuse Macomb NPPES

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

ILLINOIS MEDICAID-SUBSTANCE ABUSE MACOMB (NPI 1588032460) is a healthcare organization registered as a rehabilitation, substance use disorder in Macomb, Illinois and active in the NPI registry since September 2015. The organization lists Bill A Nelson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1588032460
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameILLINOIS MEDICAID-SUBSTANCE ABUSE MACOMB
Location Address900 S DEER RDMacomb, IL 61455-2639
Mailing Address900 S Deer RdMacomb, IL 61455-2639 · (309) 837-4876
Phone(309) 837-4876
Organization SubpartYesParent: Bridgeway Inc
Authorized OfficialBill A NelsonCeo · (309) 344-4200
Enumeration DateSeptember 9, 2015
Last NPPES UpdateAugust 19, 20192 updates tracked since enumeration
✔ NPI 1588032460 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-0118-0010-A (IL)
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X
Also ListedPsychiatry & Neurology · Child & Adolescent PsychiatryTaxonomy 2084P0804X
Also ListedClinic/Center · MethadoneTaxonomy 261QM2800X
900 S DEER RD, Macomb, IL 61455
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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 10

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

AIMEE ANDERSON QMHP
Counselor
900 S DEER RD
MACOMB, IL 61455
McDonough County (309) 837-4876
CARI COLLINS CADC
Clinic/Center (Rehabilitation, Substance Use Disorder)
900 S DEER RD
MACOMB, IL 61455
McDonough County (309) 344-2323
JOHN ROBERT PRAIN CADC
Counselor
900 S DEER RD
MACOMB, IL 61455
McDonough County (309) 837-4876
AMANDA MICHELE BOLTE CADC
Counselor (Addiction (Substance Use Disorder))
900 S DEER RD
MACOMB, IL 61455
McDonough County (309) 837-4876
BRIDGEWAY INC
Clinic/Center (Mental Health (Including Community Mental Health Center))
900 S DEER RD
MACOMB, IL 61455
McDonough County (309) 837-4876
DOROTHY J LOOP RN
Registered Nurse (Case Management)
900 S DEER RD
MACOMB, IL 61455
McDonough County (309) 837-4876
RACHELLE D MCCOY R N C
Registered Nurse (Case Management)
900 S DEER RD
MACOMB, IL 61455
McDonough County (309) 837-4876
KATHLEEN E MARKEY R.N.
Registered Nurse (Case Management)
900 S DEER RD
MACOMB, IL 61455
McDonough County (309) 837-4876

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 Macomb's NPI number?

The NPI number for Illinois Medicaid-Substance Abuse Macomb is 1588032460. It was assigned to this organization in the NPPES registry on September 9, 2015.

Where is Illinois Medicaid-Substance Abuse Macomb located?

Illinois Medicaid-Substance Abuse Macomb is located at 900 S Deer Rd, Macomb, IL 61455. The listed phone number is (309) 837-4876.

What is Illinois Medicaid-Substance Abuse Macomb'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 Macomb was last updated on August 19, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.