Organization
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Active
Parent organization
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Other names
Wm. W. Fox Developmental Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Authorized official
DEBRA MUHLSTADT (FISCAL ADMINISTRATOR, SODC OPERATIO)
(815) 288-8335
Entity
Organization
Contact information
Practice address
134 W MAIN ST, DWIGHT, IL 60420-1322
(815) 584-3347
Mailing address
134 W MAIN ST, DWIGHT, IL 60420-1322
(815) 584-3347
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
IL
Other
Enumeration date
01/18/2007
Last updated
12/22/2016
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