NPI 1053535864

Illinois Department of Human Services

Organisation Intellectual Disabilities Intermediate Care Facility Park Forest, IL

Practice location

Address: 114 N Orchard Dr, Park Forest, IL 60466-1200
Phone: (708) 283-3000
Fax: (708) 283-3020

Authorised official

Name: Debra Muhlstadt
Title: Fiscal Administrator, Sodc Operatio
Phone: (815) 288-8335

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X

Other Intermediate Care Facility, Intellectual Disabilities providers in Illinois →

Registry record

NPI: 1053535864
Entity type: Organization
NPI issued: 12 Apr 2007
Record last updated: 22 Dec 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.