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Contact Information

ILLINOIS MENTOR
600 HOLIDAY PLAZA DR
SUITE 400
MATTESON, IL60443-2241
 Phone: 708-679-9137
 Fax: 708-503-6267
 Website:
Indicates primary specialty

NPI Profile & details for ILLINOIS MENTOR

NPI # 1396954467
LBN Legal business name ILLINOIS MENTOR
Authorized official VIVIANE NGWA - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 05/22/2007
Last updated 07/21/2022 - About 4 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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