Provider Demographics
NPI:1306586631
Name:COREY & CYNTHIA F. DABNEY BEHAVIORAL HEALTH HOSPITAL
Entity type:Organization
Organization Name:COREY & CYNTHIA F. DABNEY BEHAVIORAL HEALTH HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CLINICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:
Authorized Official - Last Name:DABNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-651-6809
Mailing Address - Street 1:PO BOX 2912
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60567-2912
Mailing Address - Country:US
Mailing Address - Phone:773-651-6809
Mailing Address - Fax:
Practice Address - Street 1:845 W 69TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60621-1709
Practice Address - Country:US
Practice Address - Phone:773-651-6809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COREY & CYNTHIA F. DABNEY BEHAVIORAL HEALTH HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No251B00000XAgenciesCase Management