Organization
ILLINOIS HOUSING AND DISABILITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYROGENE MAE SAAGUNDO GABIOLA RN (CHIEF EXECUTIVE OFFICER)
(630) 470-9668
Entity
Organization
Contact information
Practice address
710 E OGDEN AVE SUITE 690, NAPERVILLE, IL 60563
(630) 470-9668
(630) 470-9133
Mailing address
710 E OGDEN AVE SUITE 690, NAPERVILLE, IL 60563
(630) 470-9668
(630) 470-9133
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
201600006C
IL
Other
Enumeration date
12/01/2016
Last updated
05/30/2023
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