NPIMap

Organization Active NPI

Habilitative Systems, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Chicago, IL
National Provider Identifier
1073068409
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
199100128C Issued in IL
Legal business name
HABILITATIVE SYSTEMS, INC.
Practice address
415 S Kilpatrick Ave
Chicago, IL 60644-4923
Phone
(773) 261-2252
Fax
(773) 854-1526
NPI assigned
Aug 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Authorized official

Name
Mr. Donald Jerome Dew, MSW
Title
President/Ceo
Phone
(773) 261-2252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 199100128C IL Primary

Addresses

Primary practice location

415 S Kilpatrick Ave
Chicago, IL 60644-4923

Mailing address

415 S Kilpatrick Ave
Chicago, IL 60644-4923
Phone (773) 261-2252

Other identifiers 1

IdentifierTypeStateIssuer
04065MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Habilitative Systems Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1073068409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S KILPATRICK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606444923",
            "telephone_number": "773-261-2252",
            "fax_number": "773-854-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S KILPATRICK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606444923",
            "telephone_number": "773-261-2252",
            "fax_number": "773-854-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HABILITATIVE SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-15",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "DEW",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "773-261-2252",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "IL",
            "license": "199100128C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04065",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.