Provider Demographics
NPI:1437649266
Name:EATING RECOVERY CENTER
Entity Type:Organization
Organization Name:EATING RECOVERY CENTER
Other - Org Name:EATING RECOVERY CENTERS OF ILLINOIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:NEVILA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDOUGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-321-2757
Mailing Address - Street 1:333 N MICHIGAN AVE STE 2107
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-4030
Mailing Address - Country:US
Mailing Address - Phone:847-274-1222
Mailing Address - Fax:
Practice Address - Street 1:1 E ERIE ST STE 400
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2785
Practice Address - Country:US
Practice Address - Phone:312-540-9955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility