Organization
MISERICORDIA HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN KNOLL (GENERAL COUNSEL / SECRETARY)
(773) 273-2729
Entity
Organization
Contact information
Practice address
6300 N RIDGE AVE, CHICAGO, IL 60660-1099
(773) 273-2038
Mailing address
6300 N RIDGE AVE, CHICAGO, IL 60660-1099
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3001256
ILLINOISDEPARTMENTOFPUBLICHEALTH
IL
Enumeration date
06/17/2026
Last updated
06/17/2026
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