NPIMap

Organization Active NPI

Milestone, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Loves Park, IL
National Provider Identifier
1710053046
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
MILESTONE, INC.
Practice address
4060 McFarland Rd
Loves Park, IL 61111-4402
Phone
(815) 654-6100
Fax
(815) 654-6444
NPI assigned
Nov 28, 2006
Last updated
Sep 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Authorized official

Name
Mr. William C. Grahn
Title
President & C.E.O.
Phone
(815) 639-2817

Specialties & licenses 1

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

Addresses

Primary practice location

4060 McFarland Rd
Loves Park, IL 61111-4402

Mailing address

4060 McFarland Rd
Loves Park, IL 61111-4402
Phone (815) 654-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060313000417 IL Part B Supplier - Mass Immunization (Roster Biller Only) 0345257507 Practice locations: Rockford, IL; Loves Park, IL

National Provider Directory

National Provider Directory
Tax ID family
Milestone Dental Clinic8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

4060 McFarland Rd
Loves Park, IL 61111
Phone (815) 639-2828

315 N Church St
Rockford, IL 61101
Phone (815) 962-6700

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1710053046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 MCFARLAND RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611114402",
            "telephone_number": "815-654-6100",
            "fax_number": "815-654-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 MCFARLAND RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611114402",
            "telephone_number": "815-654-6100",
            "fax_number": "815-654-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILESTONE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "GRAHN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT & C.E.O.",
        "authorized_official_telephone_number": "815-639-2817",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loves Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.