ADA S. MCKINLEY COMMUNITY SERVICES, INC. (NPI# 1841543394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841543394 |
| Entity Type | Organization |
| Organization Name | ADA S. MCKINLEY COMMUNITY SERVICES, INC. |
| Other Organization Name | DANFORTH HOUSE |
| Practice Address |
4540 S Michigan Ave Chicago IL 60653-3809 |
| Mailing Address |
1359 W Washington Blvd Chicago IL 60607-1905 |
| Practice Telephone | 7733731073 |
| Practice Fax Number | 7733731867 |
| Mailing Telephone | 3123852000 |
| Mailing Fax Number | 3125540292 |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2016-10-26 |
| Authorized Official Name | MRS. DONNA REE (DIRECTOR OF QUALITY ASSURANCE) |
| Authorized Official Telephone | 3123852031 |
| Authorized Official Credential | MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | IL | Residential Treatment Facilities | |
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | IDPH LICENSE | 0030577 | 01 |
| Other Name | Type Code |
|---|---|
| DANFORTH HOUSE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508246455 | Ada S. Mckinley Community Services, Inc. | Day Training, Developmentally Disabled Services | 6033 S Wentworth Ave, Chicago, IL 60621-3934 | 2015-06-05 |
| 1942553490 | Ada S. Mckinley Community Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6701 S Morgan St, Chicago, IL 60621-1201 | 2012-10-22 |
| 1538411764 | Ada S. Mckinley Community Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4237 S Indiana Ave, Chicago, IL 60653-3213 | 2012-10-11 |
| 1437401668 | Ada S. Mckinley Community Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6600 S Stewart Ave, Chicago, IL 60621-3112 | 2012-10-11 |
| 1871845008 | Ada S. Mckinley Community Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9135 South Brandon, Chicago, IL 60617-4420 | 2012-10-11 |
| 1841304219 | Ada S. Mckinley Community Services, Inc. | Hospice Care, Community Based | 2715 W. 63rd Street, Chicago, IL 60629-2305 | 2006-08-19 |
| Street Address |
4540 S MICHIGAN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60653-3809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881215804 | Pamela Ann Brazelton-sykes | Counselor | Pioneer Gardens Supportive Living, 3800 S King Dr, Chicago, IL 60653 | 2020-04-30 |
| 1962915439 | Pickup Transport Lllp | Non-emergency Medical Transport (VAN) | 4418 S. Oakenwald Ave, Chicago, IL 60653 | 2017-11-07 |
| 1245758309 | Qi Wellness LLC | Case Management | 525 E 46th Place, Chicago, IL 60653 | 2017-09-08 |
| 1598202897 | Fadesire O Ajuwon | Registered Nurse | 4218 S King Dr, 1n, Chicago, IL 60653 | 2017-01-24 |
| 1013464619 | Roundys Supermarkets Inc | Pharmacy | 3857 S Dr Martin Luther King Jr Dr, Chicago, IL 60653 | 2016-09-01 |
| 1417384793 | Griffin Orthodontics PC | Dentist | 1040 E 47th Street, Chicago, IL 60653 | 2013-10-02 |
| 1114350659 | Carita Dale Johnson | Pharmacist | 3753 S. Cottage Grove Ave, 104, Chicago, IL 60653 | 2013-08-20 |
| 1245677848 | Mercy Diagnostic and Treatment Center | Clinic/Center | 3755 S Cottage Grove, Chicago, IL 60653 | 2013-05-23 |
| 1952745937 | Mercy Community Pharmacy At Oakwood Shores | Pharmacy | 3753 S. Cottage Grove, Chicago, IL 60653 | 2013-04-22 |
| 1386952315 | Jami S Little | Developmental Therapist | 617 East 41st, Chicago, IL 60653 | 2010-09-24 |
| Find all providers in zip 60653 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588842470 | St. Mary of Providence | Intermediate Care Facility, Mentally Retarded | 4200 N Austin Ave, Chicago, IL 60634-1615 | 2008-02-04 |
| 1871650655 | Progressive Housing, Inc. | Intermediate Care Facility, Mentally Retarded | 7270 S South Shore Dr, Chicago, IL 60649-2718 | 2007-01-02 |
| 1003864844 | Misericordia Home | Intermediate Care Facility, Mentally Retarded | 6300 N Ridge Ave, Chicago, IL 60660-1017 | 2006-05-04 |
| 1861849721 | Misericordia Home | Intermediate Care Facility, Mentally Retarded | 6300 N Ridge Ave, Chicago, IL 60660-1017 | 2016-05-20 |
| 1134576093 | Misericordia Home | Intermediate Care Facility, Mentally Retarded | 6300 N Ridge Ave, Chicago, IL 60660-1017 | 2016-05-20 |
| 1871940734 | Misericordia Home | Intermediate Care Facility, Mentally Retarded | 6300 N Ridge Ave, Chicago, IL 60660-1017 | 2016-05-20 |
| 1043667900 | Misericordia Home | Intermediate Care Facility, Mentally Retarded | 6300 N Ridge Ave, Chicago, IL 60660-1017 | 2016-05-20 |
| 1447610027 | Misericordia Home | Intermediate Care Facility, Mentally Retarded | 6300 N Ridge Ave, Chicago, IL 60660-1017 | 2016-02-25 |
| 1396049391 | Misericordia Home | Intermediate Care Facility, Mentally Retarded | 6300 N Ridge Ave, Chicago, IL 60660-1017 | 2011-01-05 |
| 1972806784 | Misericordia Home | Intermediate Care Facility, Mentally Retarded | 6300 N Ridge Ave, Chicago, IL 60660-1017 | 2010-12-16 |
| Find all providers in CHICAGO | ||||
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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.