WILLOWGLEN ACADEMY-IL, INC. (NPI# 1598097016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598097016 |
| Entity Type | Organization |
| Organization Name | WILLOWGLEN ACADEMY-IL, INC. |
| Practice Address |
564 N Greenfield Dr Freeport IL 61032-2943 |
| Mailing Address |
701 W Lamm Rd Freeport IL 61032-9630 |
| Practice Telephone | 8152336162 |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2010-02-09 |
| Authorized Official Name | MRS. BETTY KINARD (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8152336162 |
| Is Organization Subpart | Y |
| Parent Organization Name | PHOENIX CARE SYSTEMS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114223245 | Willowglen Academy-il, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2011-02-08 |
| Street Address |
564 N GREENFIELD DR |
| City | FREEPORT |
| State | IL |
| Zip Code | 61032-2943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517713 | Saad Awan | Pharmacist | 2545 Illinois 26 S, Freeport, IL 61032 | 2020-10-30 |
| 1891354460 | Freeport Chiropractic LLC | Chiropractor | 2 W Stephenson St, Freeport, IL 61032 | 2019-06-07 |
| 1487168373 | Lindsey Rae Harris-baker | Speech-Language Pathologist | 1802 W Laurel St, Freeport, IL 61032 | 2017-11-30 |
| 1861871246 | Pearl Pavilion LLC | Skilled Nursing Facility | 910 Kiwanis Drive, Freeport, IL 61032 | 2015-05-19 |
| 1245584598 | Mary E Brown | Massage Therapist | 815 W. Pleasant Street, Freeport, IL 61032 | 2012-11-07 |
| 1700135803 | April Braband | Specialist | 421 Exchange, Freeport, IL 61032 | 2012-09-05 |
| 1518198662 | Quad City Prosthetic Inc | Prosthetic/Orthotic Supplier | 1013 W Loras Dr, Suite A, Freeport, IL 61032 | 2009-08-06 |
| 1447486501 | Gary Alan Besley | Dentist | 1450 S. West Ave., Freeport, IL 61032 | 2009-06-03 |
| 1023244290 | Allies In Health Sc | Chiropractor | 418 W Meadows Dr., Freeport, IL 61032 | 2009-06-02 |
| 1912146614 | Kayla Nicole Rodebaugh | Specialist/Technologist | 1010 Fairway Drive, Freeport, IL 61032 | 2009-02-19 |
| Find all providers in zip 61032 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093919797 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 239 Winnefred St., Freeport, IL 61032 | 2007-06-14 |
| 1700080629 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 Arcade Ct, Freeport, IL 61032-6040 | 2007-06-13 |
| 1982808895 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 833 S 16th Ave, Freeport, IL 61032-5921 | 2007-06-13 |
| 1386848299 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3111 W Kunkle Blvd, Freeport, IL 61032-6922 | 2007-06-13 |
| 1891999710 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 227 E Washington St, Freeport, IL 61032-5162 | 2007-06-13 |
| 1164626305 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 321 N Whistler Ave, Freeport, IL 61032-3958 | 2007-06-12 |
| 1255535498 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 730 N Brewster Ave, Freeport, IL 61032-3113 | 2007-06-12 |
| 1598969073 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1653 De Boer Ln, Freeport, IL 61032-5900 | 2007-06-11 |
| 1881100600 | Willowglen Academy Illinois | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2017-12-15 |
| 1215441050 | Willowglen Academy-illinois Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2017-11-30 |
| Find all providers in FREEPORT | ||||
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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.