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Organization

ILLINOIS DEPARTMENT OF HUMAN SERVICES

Active
Other names
Shapiro Development Center
Organization subpart
No

Provider details

NPI number
Authorized official
DEBRA MUHLSTADT (FISCAL ADMINISTRATOR, SODC OPERATIO)
(815) 288-8335
Entity
Organization

Contact information

Practice address
100 E JEFFERY ST, KANKAKEE, IL 60901-5018
(815) 939-8201
(815) 939-8266
Mailing address
100 E JEFFERY ST, KANKAKEE, IL 60901-5018
(815) 939-8201
(815) 939-8266

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
IL

Other

Enumeration date
02/02/2007
Last updated
12/22/2016
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