# GOOD SHEPHERD CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093877045
- **Authorized official:** MR. BRENDAN P MCCORMICK (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (708) 335-0020

## Contact information

- **Practice address:** 17314 KEDZIE AVE, HAZEL CREST, IL 60429-1619
- **Practice address phone:** (708) 335-0020
- **Practice address fax:** (708) 335-0022
- **Mailing address:** 17314 KEDZIE AVE, HAZEL CREST, IL 60429-1619
- **Mailing address phone:** (708) 335-0020
- **Mailing address fax:** (708) 335-0022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 261QD1600X | Developmental Disabilities Clinic/Center | 008118 | IL | Yes |
| 261QR0400X | Rehabilitation Clinic/Center | 008118 | IL | — |

## Other

- **Enumeration date:** 12/15/2006
- **Last updated:** 12/02/2015