Elisabeth Ludeman Center
Intermediate Care Facility, Intellectual Disabilities in Park Forest, IL. Organization (NPI-2).
Details
- NPI
- 1124249149
- Entity type
- Organization (NPI-2)
- Legal business name
- Elisabeth Ludeman Center
- Organization subpart
- No
- Enumeration date
- May 1, 2007
- Last updated
- Aug 22, 2020
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 code | Description | License | State | Primary |
|---|---|---|---|---|
| 315P00000X | Intermediate Care Facility, Intellectual Disabilities | – | IL | Yes |
Other names
- House 30 (Other Name)
Practice location
114 N Orchard DrPark Forest, IL 60466-1200
Phone 708-283-3000 · Fax 708-283-3020
Mailing address
114 N Orchard DrPark Forest, IL 60466-1200
Phone 708-283-3000 · Fax 708-283-3020
Authorized official
Rajani Patwari
Medical Director
7082833011
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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