NPIMap

Organization Active NPI

Maryville Academy

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Durand, IL
National Provider Identifier
1477700474
Registry record updated Aug 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
106103 Issued in IL
Legal business name
MARYVILLE ACADEMY
Practice address
10102 Farm School Rd
Durand, IL 61024-9725
Phone
(815) 599-3801
NPI assigned
Aug 20, 2008
Last updated
Aug 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2008

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

Authorized official

Name
Miss Maura Harrington
Title
Controller
Phone
(847) 294-1826

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 106103 IL Primary

Addresses

Primary practice location

10102 Farm School Rd
Durand, IL 61024-9725

Mailing address

1150 N River Rd
Des Plaines, IL 60016-1214

National Provider Directory

National Provider Directory
Tax ID family
Maryville Academy28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Locations

10102 Farm School Rd
Durand, IL 61024
Phone (815) 599-3801

NPI Registry JSON

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1477700474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N RIVER RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10102 FARM SCHOOL RD",
            "city": "DURAND",
            "state": "IL",
            "postal_code": "610249725",
            "telephone_number": "815-599-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYVILLE ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-20",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "HARRINGTON",
        "authorized_official_first_name": "MAURA",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "847-294-1826",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "IL",
            "license": "106103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durand, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.