National Provider Identifier Database

DISABILITY SERVICES OF ILLINOIS NFP
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities


Contact Information

DISABILITY SERVICES OF ILLINOIS NFP
286 E 16TH ST
CHICAGO HEIGHTS, IL60411-3730
Phone: 708-753-1670
Fax: 708-753-1679
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320900000X
Case Management 251B00000X
Day Training, Developmentally Disabled Services 251C00000X

* Indicates primary specialty

NPI Profile & details for DISABILITY SERVICES OF ILLINOIS NFP

NPI Number 1477919546
Legal business name
LBN
DISABILITY SERVICES OF ILLINOIS NFP
Authorized official REUBEN GOODWIN - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 01/05/2016
Last updated 01/05/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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