Provider Demographics
NPI:1306417944
Name:DUI DEPOT, LLC
Entity Type:Organization
Organization Name:DUI DEPOT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDDINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CADC
Authorized Official - Phone:773-707-1990
Mailing Address - Street 1:25 N RIVER LN # 114
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2263
Mailing Address - Country:US
Mailing Address - Phone:224-499-3699
Mailing Address - Fax:888-740-7373
Practice Address - Street 1:25 N RIVER LN # 114
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2263
Practice Address - Country:US
Practice Address - Phone:224-499-3699
Practice Address - Fax:888-740-7373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility