Countryside Association for People With Disabilities, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COUNTRYSIDE ASSOCIATION FOR PEOPLE WITH DISABILITIES, INC.

Practice address

21154 W Shirley Rd
Palatine, IL 60074-2028

Phone

(847) 438-8855

Fax

(847) 438-9698

NPI assigned

Feb 23, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Wayne A. Kulick

Title

Executive Director

Phone

(847) 438-8855

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1770618282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21154 W SHIRLEY RD",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600742028",
            "telephone_number": "847-438-8855",
            "fax_number": "847-438-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21154 W SHIRLEY RD",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600742028",
            "telephone_number": "847-438-8855",
            "fax_number": "847-438-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE ASSOCIATION FOR PEOPLE WITH DISABILITIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KULICK",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "847-438-8855",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.