Illinois Department of Human Services

NPI #1376525204 in Dixon, Illinois

Provider Information

NPI Number
1376525204
Entity Type
Organization
Organization Name
Illinois Department of Human Services
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Nov 16, 2005
Last Updated
Dec 22, 2016

Practice Location

Address
1120 WASHINGTON AVE
City
Dixon
ZIP Code
61021-1258
Phone
(815) 288-8301

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Intermediate Care Facility, Intellectual Disabilities

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