Illinois Department of Human Services

NPI #1265584155 in Dwight, Illinois

Provider Information

NPI Number
1265584155
Entity Type
Organization
Organization Name
Illinois Department of Human Services
Subpart
Yes (part of a larger organization)
Parent Organization
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Jan 18, 2007
Last Updated
Dec 22, 2016

Practice Location

Address
134 W MAIN ST
City
Dwight
ZIP Code
60420-1322
Phone
(815) 584-3347

Authorized Official

Name
DEBRA MUHLSTADT
Title
FISCAL ADMINISTRATOR, SODC OPERATIO
Phone
(815) 288-8335

Specialties & Taxonomy Codes

Specialty
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Intermediate Care Facility, Intellectual Disabilities

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