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

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

National Provider Directory

Tax ID family
Howe Center - Unit 4264 (292 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Waukegan, IL

All providers in Waukegan, IL · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Illinois

Sources for this page

Verify at the official NPI Registry.