RINCON FAMILY SERVICES NPI 1093164824

NPI Information

NPI: 1093164824
Provider Name: RINCON FAMILY SERVICES
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
5453 W DIVERSEY AVE
CHICAGO, IL
ZIP 60639
Phone: (888) 215-0513
Get Directions

RINCON FAMILY SERVICES is a rehabilitation and substance use disorder clinic center in Chicago, IL. RINCON FAMILY SERVICES NPI is 1093164824. The provider is registered as an organization entity type.

The provider's business location address is:

5453 W DIVERSEY AVE
CHICAGO, IL
ZIP 60639-413
Phone: (888) 215-0513
Fax: (773) 417-3293

The provider's authorized official is Eddy Borrayo .
The authorized official title is President/ceo and has the following contact phone number (773) 564-9070.

The enumeration date for this NPI number is 6/13/2016 and was last updated on 11/1/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0488	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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