Mount St Joseph

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

MOUNT ST JOSEPH

Practice address

24955 N Highway 12
Lake Zurich, IL 60047

Phone

(847) 438-5050

Fax

(847) 719-1060

NPI assigned

Sep 22, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Janet Kosman

Title

Administrator/Director

Phone

(847) 438-5050

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033219803. Details of each certification follow.

• CCN 14G031 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 14G031

Legal name

MOUNT ST JOSEPH

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

May 8, 1976

Last certification

Mar 6, 2025

Beds

129

Ownership / control type

Private (non-profit)

Facility address

24955 North Highway 12
Lake Zurich, IL 60047

Tax ID family

Mount St Joseph3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Mount St Joseph

  • Developmentally Disabled Services Day Training Agency
  • Lake Zurich, IL
  • NPI 1659993590
  NPD tax ID
• Mount St Joseph

  • Intellectual Disabilities Intermediate Care Facility
  • Lake Zurich, IL
  • NPI 1871039669
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1033219803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24955 N HIGHWAY 12",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "60047",
            "telephone_number": "847-438-5050",
            "fax_number": "847-719-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24955 N HIGHWAY 12",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "60047",
            "telephone_number": "847-438-5050",
            "fax_number": "847-719-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT ST JOSEPH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A",
        "authorized_official_last_name": "KOSMAN",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "ADMINISTRATOR/DIRECTOR",
        "authorized_official_telephone_number": "847-438-5050"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "0005520",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maja Mirjanic
• San P Mo, L.P.C.
• Kristin Nicole Moore, DMD, MS
• Patrick Joseph Morris, D.C.
• Cori Moschberger, LCSW
• Mount St Joseph
• Mount St Joseph
• Antonia Mourelatos, O.D.
• Christine Moyer, BCBA
• Mary Mueller, PA

• Intellectual Disabilities Intermediate Care Facility in Lake Zurich, IL
• Providers in Lake Zurich, IL by specialty
• Intellectual Disabilities Intermediate Care Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.