# ILLINOIS MENTOR, INC.

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

## Provider details

- **NPI number:** 1518532852
- **Authorized official:** MS. LORI REBECCA WRIGHT (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (715) 536-4023

## Contact information

- **Practice address:** 18440 THOMPSON CT STE 104, TINLEY PARK, IL 60477-5427
- **Practice address phone:** (815) 464-3239
- **Mailing address:** 18440 THOMPSON CT STE 104, TINLEY PARK, IL 60477-5427

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/20/2021
- **Last updated:** 05/20/2021