NPIMap

Organization Active NPI

Ann Kiley Developmental Center Unit 3561 Home 41

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Waukegan, IL
National Provider Identifier
1861520876
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
ANN KILEY DEVELOPMENTAL CENTER UNIT 3561 HOME 41
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

NPPES NPI Registry
Name
Dr. Pratihba Malhotra, M.D.
Title
Medical Director
Phone
(847) 249-0600

National Provider Directory

National Provider Directory
Tax ID family
Howe Center - Unit 4264292 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861520876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 W DUGDALE RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600856263",
            "telephone_number": "847-249-0600",
            "fax_number": "847-249-4587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W DUGDALE RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600856263",
            "telephone_number": "847-249-0600",
            "fax_number": "847-249-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN KILEY DEVELOPMENTAL CENTER UNIT 3561 HOME 41",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MALHOTRA",
        "authorized_official_first_name": "PRATIHBA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "847-249-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "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 Waukegan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.