ILLINOIS DEPARTMENT OF HUMAN SERVICES NPI 1053535864

NPI Information

NPI: 1053535864
Provider Name: ILLINOIS DEPARTMENT OF HUMAN SERVICES

Other Name: ELISABETH LUDEMAN DEVELOPMENTAL CENTER

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
114 N ORCHARD DR
PARK FOREST, IL
ZIP 60466
Phone: (708) 283-3000
Get Directions

ILLINOIS DEPARTMENT OF HUMAN SERVICES is an intermediate care facility mentally retarded in Park Forest, IL. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. ILLINOIS DEPARTMENT OF HUMAN SERVICES NPI is 1053535864. The provider is registered as an organization entity type.
The provider Other Name Is Elisabeth Ludeman Developmental Center.

The provider's business location address is:

114 N ORCHARD DR
PARK FOREST, IL
ZIP 60466-200
Phone: (708) 283-3000
Fax: (708) 283-3020

The provider's authorized official is Debra Muhlstadt .
The authorized official title is Fiscal Administrator, Sodc Operatio and has the following contact phone number (815) 288-8335.

The enumeration date for this NPI number is 4/12/2007 and was last updated on 12/22/2016.

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	315P00000X	Intermediate Care Facility, Intellectual Disabilities			ILLINOIS	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	000950111001	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: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »