Organization
ANN KILEY DEVELOPMENTAL CENTER UNIT 3169
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRATIHBA MALHOTRA M.D. (MEDICAL DIRECTOR)
(847) 249-0600
Entity
Organization
Contact information
Practice address
1401 W DUGDALE RD, WAUKEGAN, IL 60085-6263
(847) 249-0600
(847) 249-4587
Mailing address
1401 W DUGDALE RD, WAUKEGAN, IL 60085-6263
(847) 249-0600
(847) 249-4587
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/28/2007
Last updated
08/22/2020
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