NPIMap

Organization Active NPI

Childrens Home and Aid Society of Illinois

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IL
National Provider Identifier
1417198920
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
004236 Issued in IL
Legal business name
CHILDRENS HOME AND AID SOCIETY OF ILLINOIS
Doing business as
Childrens Home and Aid
Practice address
403 S State St
Bloomington, IL 61701-5556
Phone
(309) 834-5277
Fax
(309) 828-0745
NPI assigned
Mar 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Authorized official

Name
Mike Shaver
Title
President/Ceo
Phone
(312) 424-6801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 004236 IL Primary

Addresses

Primary practice location

403 S State St
Bloomington, IL 61701-5556

Mailing address

200 W Monroe St Ste 2100
Chicago, IL 60606-5071
Phone (312) 424-0200

Other identifiers 1

IdentifierTypeStateIssuer
004236MedicaidIL

Other names 1

  • Childrens Home and Aid Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Children'S Home and Aid21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Locations

403 S State St
Bloomington, IL 61701
Phone (309) 265-0213

NPI Registry JSON

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

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767830400000",
    "number": "1417198920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W MONROE ST STE 2100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606065071",
            "telephone_number": "312-424-0200",
            "fax_number": "312-424-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 S STATE ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015556",
            "telephone_number": "309-834-5277",
            "fax_number": "309-828-0745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS HOME AND AID SOCIETY OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-12",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A",
        "authorized_official_last_name": "SHAVER",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "312-424-6801"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "004236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Childrens Home and Aid",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Childrens Home and Aid",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; 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.