NPIMap

Organization Active NPI

0013 Elisabeth Ludeman Center

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Park Forest, IL
National Provider Identifier
1649300690
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
000953261001 Issued in IL
Legal business name
0013 ELISABETH LUDEMAN CENTER
Practice address
114 N Orchard Dr
Park Forest, IL 60466-1200
Phone
(708) 283-3000
Fax
(708) 283-3020
NPI assigned
Mar 7, 2007
Last updated
Jun 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Authorized official

Name
Mr. David I Decker
Title
Center Director
Phone
(708) 283-3001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 000953261001 IL Primary

Addresses

Primary practice location

114 N Orchard Dr
Park Forest, IL 60466-1200

Mailing address

114 N Orchard Dr
Park Forest, IL 60466-1200
Phone (708) 283-3000

Other identifiers 1

IdentifierTypeStateIssuer
000953261001MedicaidIL

Other names 1

  • Home 13 Other name

National Provider Directory

National Provider Directory
Tax ID family
Elisabeth Ludeman Center292 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1649300690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N ORCHARD DR",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604661200",
            "telephone_number": "708-283-3000",
            "fax_number": "708-283-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N ORCHARD DR",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604661200",
            "telephone_number": "708-283-3000",
            "fax_number": "708-283-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "0013 ELISABETH LUDEMAN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CENTER DIRECTOR",
        "authorized_official_telephone_number": "708-283-3001",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "000953261001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000953261001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home 13",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Park Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.