NPIMap

Organization Active NPI

Ada S. McKinley Community Services, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Chicago, IL
National Provider Identifier
1841543394
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
ADA S. MCKINLEY COMMUNITY SERVICES, INC.
Doing business as
DANFORTH HOUSE
Practice address
4540 S Michigan Ave
Chicago, IL 60653-3809
Phone
(773) 373-1073
Fax
(773) 373-1867
NPI assigned
Oct 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Authorized official

Name
Ken Fries
Title
Dir Qa&C
Phone
(312) 385-2022

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X IL

Addresses

Primary practice location

4540 S Michigan Ave
Chicago, IL 60653-3809

Mailing address

1359 W Washington Blvd
Chicago, IL 60607-1905
Phone (312) 385-2000

Other identifiers 1

IdentifierTypeStateIssuer
0030577OtherILIDPH LICENSE

Other names 1

  • DANFORTH HOUSE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 14G124

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
DANFORTH HOUSE
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Nov 21, 1986
Last certification
Jul 17, 2024
Beds
15
Ownership / control type
Private (non-profit)
Facility address
4540 South Michigan Avenue
Chicago, IL 60653

National Provider Directory

National Provider Directory
Tax ID family
Ada S McKinley Community Services Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

4540 S Michigan Ave
Chicago, IL 60653
Phone (773) 373-1073

NPI Registry JSON

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746489600000",
    "number": "1841543394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1359 W WASHINGTON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071905",
            "telephone_number": "312-385-2000",
            "fax_number": "312-554-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533809",
            "telephone_number": "773-373-1073",
            "fax_number": "773-373-1867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADA S. MCKINLEY COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-22",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A",
        "authorized_official_last_name": "FRIES",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "DIR QA&C",
        "authorized_official_telephone_number": "312-385-2022"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDPH LICENSE",
            "identifier": "0030577",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DANFORTH HOUSE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.