Ann Kiley Developmental Center Unit 3566 Home 46
Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Waukegan, IL
NPI 1770611642 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1770611642
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
- Legal business name
- ANN KILEY DEVELOPMENTAL CENTER UNIT 3566 HOME 46
- Practice address
- 1401 W Dugdale Rd
Waukegan, IL 60085-6263 - Phone
- (847) 249-0600
- Fax
- (847) 249-4587
- NPI assigned
- Mar 1, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Pratihba Malhotra, M.D.
- Title
- Medical Director
- Phone
- (847) 249-0600
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Howe Center - Unit 4264
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | Yes |
Addresses
Primary practice location
1401 W Dugdale Rd
Waukegan, IL 60085-6263
Mailing address
1401 W Dugdale Rd
Waukegan, IL 60085-6263
Phone (847) 249-0600
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All providers in Waukegan, IL · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.