NPIMap

Organization Active NPI

Elisabeth Ludeman Center

  • Intellectual Disabilities Intermediate Care Facility
  • Park Forest, IL
National Provider Identifier
1104047281
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
ELISABETH LUDEMAN CENTER
Practice address
114 N Orchard Dr
Park Forest, IL 60466-1200
Phone
(708) 283-3000
Fax
(708) 283-3020
NPI assigned
May 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Rajani Patwari, M.D.
Title
Medical Director
Phone
(708) 283-3011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X IL Primary

Addresses

Primary practice location

114 N Orchard Dr
Park Forest, IL 60466-1200

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
000950445001MedicaidIL

Other names 1

  • House 45 Other name

National Provider Directory

National Provider Directory
Tax ID family
Howe Center - Unit 4264292 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104047281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N ORCHARD DR",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604661200",
            "telephone_number": "708-283-3000",
            "fax_number": "708-283-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N ORCHARD DR",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604661200",
            "telephone_number": "708-283-3000",
            "fax_number": "708-283-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELISABETH LUDEMAN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATWARI",
        "authorized_official_first_name": "RAJANI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "708-283-3011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000950445001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "House 45",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Park Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.