# ELISABETH LUDEMAN CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** House 23
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871713958
- **Authorized official:** DR. RAJANI PATWARI M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (708) 283-3011

## Contact information

- **Practice address:** 114 N ORCHARD DR, PARK FOREST, IL 60466-1200
- **Practice address phone:** (708) 283-3000
- **Practice address fax:** (708) 283-3020
- **Mailing address:** 114 N ORCHARD DR, PARK FOREST, IL 60466-1200
- **Mailing address phone:** (708) 283-3000
- **Mailing address fax:** (708) 283-3020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 315P00000X | Intellectual Disabilities Intermediate Care Facility | — | IL | Yes |

## Other

- **Enumeration date:** 04/30/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000950223001 | — | IL |