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Illinois Children & Family Development Center LLC

Community/Behavioral Health in Chicago, IL. Organization (NPI-2).

NPI number1013590793
StatusActive
Last updated in NPPESApr 30, 2021

Details

NPI
1013590793
Entity type
Organization (NPI-2)
Legal business name
Illinois Children & Family Development Center LLC
Organization subpart
No
Enumeration date
Apr 30, 2021
Certification date
Apr 30, 2021
Last updated
Apr 30, 2021

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health––Yes
251C00000X Day Training, Developmentally Disabled Services––
252Y00000X Early Intervention Provider Agency––
320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities––
322D00000X Residential Treatment Facility, Emotionally Disturbed Children––
251B00000X Case Management––

Practice location

47 W Polk St Ste 100-240
Chicago, IL 60605-2000

Phone 708-971-0966

Mailing address

47 W Polk St Ste 100-240
Chicago, IL 60605-2000

Authorized official

Timeica Bethel
Chief Executive Officer
7089710966

Is something wrong?

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