| Organization Name: | ANN KILEY DEVELOPMENTAL CENTER UNIT 3366 HOME 26 |
| NPI Number: | 1023146297 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PRATIHBA MALHOTRA (MEDICAL DIRECTOR) |
| Mailing Address: | 1401 W Dugdale Rd Waukegan |
| State: | IL US |
| Postal Code: | 600856263 |
| Phone Number: | 8472490600 |
| Fax Number: | 8472494587 |
| NPI Enumeration Date: | 03/01/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 320600000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |