WILLOWGLEN ACADEMY ILLINOIS (NPI# 1811449523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811449523 |
| Entity Type | Organization |
| Organization Name | WILLOWGLEN ACADEMY ILLINOIS |
| Practice Address |
701 W Lamm Rd Freeport IL 61032-9630 |
| Practice Telephone | 8152336162 |
| Mailing Telephone | 8152336162 |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2016-10-28 |
| Authorized Official Name | SAMANTHA JO CUSIMANO (QIDP) |
| Authorized Official Telephone | 8152336162 |
| 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 | IL | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| Street Address |
701 W LAMM RD |
| City | FREEPORT |
| State | IL |
| Zip Code | 61032-9630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285838458 | Judy Ann Strey | Speech-Language Pathologist | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2007-06-12 |
| 1225544901 | Gloria Ann Ennenbach | Registered Nurse | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2017-12-18 |
| 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 |
| 1548703887 | Ervin Wainwright | Social Worker | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-18 |
| 1932641164 | Erik Walton | Social Worker | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-04 |
| 1558803783 | Antoinette Harvey | Social Worker | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-04 |
| 1740732908 | Martrice Collier | Social Worker | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-03 |
| 1184176448 | Roland Emeka Aguocha | Social Worker | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-02 |
| 1194277541 | Carrie Snow | Counselor | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-02 |
| Find all providers in the same location | ||||
| 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 | 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 |
|---|---|---|---|---|
| 1710439435 | Willowglen Academy | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689218273 | Dymond Homes LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4223 S Prairie Ave, Chicago, IL 60653-3211 | 2019-11-06 |
| 1447782396 | Light of Hope | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 22858 Millard Ave, Richton Park, IL 60471-2531 | 2017-03-30 |
| 1760831945 | Nucare Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 18118 Orleans Dr, Hazel Crest, IL 60429-2242 | 2016-06-08 |
| 1649629346 | Catina Ballin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8808 Riley Road, Wonderlake, IL 60097 | 2016-06-03 |
| 1003262254 | Patterson House Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 717 E 1st South St, Carlinville, IL 62626-1922 | 2016-05-06 |
| 1235592288 | Ray Graham Association | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 901 Warrenville Rd, Suite 500, Lisle, IL 60532-4301 | 2016-03-29 |
| 1962867796 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1315 N Curran Rd, Mchenry, IL 60050-6520 | 2015-12-21 |
| 1942675228 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 N Hart St, Harvard, IL 60033-2227 | 2015-12-11 |
| 1518332881 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 851 W Main St, Cary, IL 60013-1920 | 2015-12-11 |
| 1083089361 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 455 Huntley Rd, Crystal Lake, IL 60014-5318 | 2015-12-11 |
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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.