NPIMap

Organization Active NPI

Association for Individual Development

  • Intellectual Disabilities Intermediate Care Facility
  • Aurora, IL
National Provider Identifier
1619129715
Registry record updated Oct 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
0034108 Issued in IL
Legal business name
ASSOCIATION FOR INDIVIDUAL DEVELOPMENT
Practice address
421 N Constitution Dr
Aurora, IL 60506-3209
Phone
(630) 859-7650
Fax
(630) 859-1780
NPI assigned
Oct 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2008

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

Authorized official

Name
Ms. Lynn O'Shea
Title
President
Phone
(630) 966-4001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 0034108 IL Primary

Addresses

Primary practice location

421 N Constitution Dr
Aurora, IL 60506-3209

Mailing address

309 W. New Indian Trail Court
Aurora, IL 60506-2494
Phone (630) 966-4168

Other names 1

  • AID- Tac House Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619129715. Details of each certification follow.

  • CCN 14G228 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 14G228

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
TAC HOUSE
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Nov 29, 1989
Last certification
Aug 16, 2024
Beds
16
Ownership / control type
Private (non-profit)
Facility address
421 Constitution Drive
Aurora, IL 60506

National Provider Directory

National Provider Directory
Tax ID family
Aid40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

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

View all 39

Locations

421 N Constitution Dr
Aurora, IL 60506
Phone (630) 859-7650

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225411200000",
    "number": "1619129715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 W. NEW INDIAN TRAIL COURT",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605062494",
            "telephone_number": "630-966-4168",
            "fax_number": "630-844-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 N CONSTITUTION DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605063209",
            "telephone_number": "630-859-7650",
            "fax_number": "630-859-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATION FOR INDIVIDUAL DEVELOPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-31",
        "status": "A",
        "authorized_official_last_name": "O'SHEA",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-966-4001",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IL",
            "license": "0034108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AID- Tac House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.