FOOTPRINTS RECOVERY IL LLC NPI 1104582154

NPI Information

  • NPI: 1104582154
  • Provider Name: FOOTPRINTS RECOVERY IL LLC
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • CLIA Number: 14D2245239
  • Address: 411 W RIVER RD
    ELGIN, IL
    ZIP 60123
  • Phone: (224) 347-4025

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NPI Details

FOOTPRINTS RECOVERY IL LLC is a rehabilitation and substance use disorder clinic center in Elgin, IL. FOOTPRINTS RECOVERY IL LLC NPI is 1104582154. The provider is registered as an organization entity type.

The provider's business location address is:

411 W RIVER RD
ELGIN, IL
ZIP 60123-570
Phone: (224) 347-4025

The provider's authorized official is Janice Vaysberg .
The authorized official title is Cfo and has the following contact phone number (847) 345-5541.

The CLIA number assigned to this NPI record is 14D2245239 - other - substance abuse trtmt ctr with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/15/2021 and was last updated on 5/20/2025.

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
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

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: 11/21/2025

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