NPIMap

Organization Active NPI

St. Coletta's of Illinois, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Tinley Park, IL
National Provider Identifier
1295195295
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
199100115C Issued in IL
Legal business name
ST. COLETTA'S OF ILLINOIS, INC.
Practice address
18350 Crossing Dr
Tinley Park, IL 60487-6294
Phone
(708) 342-5200
NPI assigned
Mar 3, 2016
Last updated
Mar 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Mrs. Annette Skafgaard
Title
Vice President of Finance & Operati
Phone
(708) 342-5253

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 199100115C IL Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 199100115C IL

Addresses

Primary practice location

18350 Crossing Dr
Tinley Park, IL 60487-6294

Mailing address

18350 Crossing Dr
Tinley Park, IL 60487-6294
Phone (708) 342-5200

National Provider Directory

National Provider Directory
Tax ID family
St Coletta's of Illinois4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1295195295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18350 CROSSING DR",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604876294",
            "telephone_number": "708-342-5200",
            "fax_number": "708-342-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18350 CROSSING DR",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604876294",
            "telephone_number": "708-342-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. COLETTA'S OF ILLINOIS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-03",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "SKAFGAARD",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE & OPERATI",
        "authorized_official_telephone_number": "708-342-5253",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "IL",
            "license": "199100115C",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "199100115C",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.