ANN KILEY DEVELOPMENTAL CENTER UNIT 3564 HOME 44 (NPI# 1053449074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053449074 |
| Entity Type | Organization |
| Organization Name | ANN KILEY DEVELOPMENTAL CENTER UNIT 3564 HOME 44 |
| Practice Address |
1401 W Dugdale Rd Waukegan IL 60085-6263 |
| Practice Telephone | 8472490600 |
| Practice Fax Number | 8472494587 |
| Mailing Telephone | 8472490600 |
| Mailing Fax Number | 8472494587 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. PRATIHBA MALHOTRA (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8472490600 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
1401 W DUGDALE RD |
| City | WAUKEGAN |
| State | IL |
| Zip Code | 60085-6263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629089818 | Pratibha Katyal Malhotra | Pediatrics | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2006-08-11 |
| 1588793616 | Ann Kiley Developmental Center Unit 3468 Home 38 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-05 |
| 1619005592 | Ann Kiley Developmental Center Unit 3568 Home 48 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| 1528196409 | Ann Kiley Developmental Center Unit 3569 Home 49 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| 1164550042 | Ann Kiley Developmental Center Unit 3570 Home 50 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| 1174651178 | Ann Kiley Developmental Center Unit 3466 Home 36 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| 1326176322 | Ann Kiley Developmetal Center Unit 3467 Home37 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| 1649308651 | Ann Kiley Developmental Center Unit 3562 Home 42 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| 1023146156 | Ann Kiley Developmental Center Unit 3464 Home 34 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| 1386772416 | Ann Kiley Developmental Center Unit 3465 Home 35 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285285189 | Allison Rose Matuszewski | Speech-Language Pathologist | Robbie M. Lightfoot, 1721 N Mcaree Rd, Waukegan, IL 60085 | 2019-09-23 |
| 1164985602 | Kristin Kaprak | Speech-Language Pathologist | Thomas Jefferson Middle School, 600 S. Lewis, Waukegan, IL 60085 | 2019-04-11 |
| 1861972317 | Mitchum Smith | Student in an Organized Health Care Education/Training Program | 2025 Washington Street, Waukegan, IL 60085 | 2018-08-15 |
| 1447702998 | Rachel Martinez | Registered Nurse | 3002 Grand Ave., Waukegan, IL 60085 | 2016-11-01 |
| 1831649250 | Kenneth Caples | Specialist/Technologist | 211 S County St, Waukegan, IL 60085 | 2016-10-10 |
| 1033666490 | Catholic Charities of The Archdiocese of Chicago | Community/Behavioral Health | 671 S. Lewis Ave., Waukegan, IL 60085 | 2016-09-02 |
| 1285007757 | Michael Moore | Counselor | 1113 Greenwood Ave, Waukegan, IL 60085 | 2015-11-05 |
| 1740656503 | Emperatriz Guerra | Counselor | 329 N. Genesee Street, Waukegan, IL 60085 | 2015-08-17 |
| 1992189880 | County of Lake | Clinic/Center | 540 S. Mcalister Ave., Waukegan, IL 60085 | 2015-07-10 |
| 1922406354 | Ebele Okonkwor | Nurse Anesthetist, Certified Registered | 1324 N. Sheridan, Waukegan, IL 60085 | 2014-12-17 |
| Find all providers in zip 60085 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588793616 | Ann Kiley Developmental Center Unit 3468 Home 38 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-05 |
| 1619005592 | Ann Kiley Developmental Center Unit 3568 Home 48 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| 1528196409 | Ann Kiley Developmental Center Unit 3569 Home 49 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| 1164550042 | Ann Kiley Developmental Center Unit 3570 Home 50 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| 1174651178 | Ann Kiley Developmental Center Unit 3466 Home 36 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| 1326176322 | Ann Kiley Developmetal Center Unit 3467 Home37 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| 1649308651 | Ann Kiley Developmental Center Unit 3562 Home 42 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| 1023146156 | Ann Kiley Developmental Center Unit 3464 Home 34 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| 1386772416 | Ann Kiley Developmental Center Unit 3465 Home 35 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| 1770611642 | Ann Kiley Developmental Center Unit 3566 Home 46 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1401 W Dugdale Rd, Waukegan, IL 60085-6263 | 2007-03-01 |
| Find all providers in WAUKEGAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.