Illinois Department of Human Sevices

NPI #1679639967 in Waukegan, Illinois

Provider Information

NPI Number
1679639967
Entity Type
Organization
Organization Name
Illinois Department of Human Sevices
Subpart
Yes (part of a larger organization)
Parent Organization
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Dec 29, 2006
Last Updated
Dec 22, 2016

Practice Location

Address
1401 W DUGDALE RD
ZIP Code
60085
Phone
(847) 249-0600

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Developmental DisabilitiesDevelopmental Disabilities
Intermediate Care Facility, Intellectual Disabilities

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