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Contact Information

GOOD SHEPHERD CENTER
17314 KEDZIE AVE
HAZEL CREST, IL60429-1619
 Phone: 708-335-0020
 Fax: 708-335-0022
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Developmental Disabilities

261QD1600X
 

Case Management

251B00000X
 

Rehabilitation

261QR0400X B4[14] Rehabilitation Agency
Indicates primary specialty

NPI Profile & details for GOOD SHEPHERD CENTER

NPI Number 1093877045
LBN Legal business name GOOD SHEPHERD CENTER
Authorized official BRENDAN MCCORMICK - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 12/15/2006
Last updated 12/02/2015 - About 11 years ago
Identifiers
IL License # 008118
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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