Serenity Village of Illinois

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SERENITY VILLAGE OF ILLINOIS

Practice address

12507 S Justine St
Calumet Park, IL 60827-6017

Phone

(708) 513-8853

NPI assigned

May 14, 2025

Organization subpart

No

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

Authorized official

Name

Adetayo Adelekan, RN

Title

Chairman of the Board of Directors

Phone

(708) 513-8853

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1747180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1609667195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10824 S HALE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606433342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12507 S JUSTINE ST",
            "city": "CALUMET PARK",
            "state": "IL",
            "postal_code": "608276017",
            "telephone_number": "708-513-8853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY VILLAGE OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-14",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "ADELEKAN",
        "authorized_official_first_name": "ADETAYO",
        "authorized_official_title_or_position": "CHAIRMAN OF THE BOARD OF DIRECTORS",
        "authorized_official_telephone_number": "708-513-8853",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Calumet Park, IL
• Providers in Calumet Park, IL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; 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.