NPIMap

Organization Active NPI

Ada S. McKinley Community Services, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Chicago, IL
National Provider Identifier
1871845008
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
Moore House
Practice address
9135 South Brandon
Chicago, IL 60617-4420
Phone
(773) 731-4033
Fax
(773) 731-2376
NPI assigned
Oct 11, 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 0005 IL

Addresses

Primary practice location

9135 South Brandon
Chicago, IL 60617-4420

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0030593OtherILIDPH LICENSE

Other names 1

  • Moore House Doing business as

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

9135 S Brandon Ave
Chicago, IL 60617
Phone (773) 731-4033

NPI Registry JSON

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746489600000",
    "number": "1871845008",
    "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": "9135 SOUTH BRANDON",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174420",
            "telephone_number": "773-731-4033",
            "fax_number": "773-731-2376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADA S. MCKINLEY COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-11",
        "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": "0005",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDPH LICENSE",
            "identifier": "0030593",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moore House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.