ILLINOIS DEPARTMENT OF HUMAN SERVICES (NPI# 1548305675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548305675 |
| Entity Type | Organization |
| Organization Name | ILLINOIS DEPARTMENT OF HUMAN SERVICES |
| Other Organization Name | MURRAY DEVELOPMENTAL CENTER |
| Practice Address |
1535 W Mccord St Centralia IL 62801-5805 |
| Practice Telephone | 6185321811 |
| Practice Fax Number | 6185327464 |
| Mailing Telephone | 6185321811 |
| Mailing Fax Number | 6185327464 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2008-06-20 |
| Authorized Official Name | JAMES VEACH (CENTER DIRECTOR) |
| Authorized Official Telephone | 6185321811 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 805-8000 | IL | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 14-G053 | 05 | |
| IL | 000583164001 | 05 |
| Other Name | Type Code |
|---|---|
| Murray Developmental Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467430124 | Illinois Department of Human Services | Psychiatric Hospital | 901 Southwind Dr, Springfield, IL 62703-5125 | 2006-01-04 |
| 1376525204 | Illinois Department of Human Services | Intermediate Care Facility, Mentally Retarded | 1120 Washington Ave, Dixon, IL 61021-1258 | 2005-11-16 |
| 1356338198 | Illinois Department of Human Services | Psychiatric Hospital | 4402 N Main St, Rockford, IL 61103-1278 | 2005-10-05 |
| 1053535864 | Illinois Department of Human Services | Intermediate Care Facility, Mentally Retarded | 114 N Orchard Dr, Park Forest, IL 60466-1200 | 2007-04-12 |
| 1154453991 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1000 N Main St, Anna, IL 62906-1652 | 2007-03-09 |
| 1639214760 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-20 |
| 1437294568 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-20 |
| 1346385473 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-20 |
| 1053456186 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-20 |
| 1932244860 | Illinois Department of Human Services | Psychiatric Unit | 4500 College Ave, Alton, IL 62002 | 2007-02-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ILLINOIS DEPARTMENT OF HUMAN SERVICES | 401 S Clinton St, Chicago, IL 60607-3800 |
| Street Address |
1535 W MCCORD ST |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62801-5805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982710133 | Nazir Ahmad | Pediatrics | 1535 W Mccord St, Centralia, IL 62801 | 2006-08-21 |
| 1003433723 | Dale D Pearce | Nurse Practitioner | 1535 W Mccord St, Centralia, IL 62801-5805 | 2020-06-29 |
| 1316454085 | Jessica Lynn Chapman | Nurse Practitioner | 1535 W Mccord St, Centralia, IL 62801-5805 | 2018-01-04 |
| 1639214760 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-20 |
| 1437294568 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-20 |
| 1346385473 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-20 |
| 1053456186 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-20 |
| 1619012747 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-20 |
| 1538203419 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-16 |
| 1447394325 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1629573365 | Prabhat Shrestha | Student in an Organized Health Care Education/Training Program | 605 Sable Drive, Centralia, IL 62801 | 2018-03-26 |
| 1619496098 | Whitney Rathmann | Speech-Language Pathologist | 224 South Locust, Centralia, IL 62801 | 2017-09-17 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| 1568820637 | Midland Area Agency On Aging | Case Management | 434 S Poplar Street, Centralia, IL 62801 | 2016-02-04 |
| 1104201714 | Keri Douglas | Nurse Practitioner | 1054 M. L. King Drive #125, Centrailia, IL 62801 | 2015-07-24 |
| 1215331509 | Melissa Dane | Counselor | 904 E Martin Luther King Dr., Centralia, IL 62801 | 2014-10-15 |
| Find all providers in zip 62801 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639214760 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-20 |
| 1437294568 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-20 |
| 1346385473 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-20 |
| 1053456186 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-20 |
| 1619012747 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-20 |
| 1538203419 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-16 |
| 1447394325 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-02-16 |
| 1003960394 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1535 W Mccord St, Centralia, IL 62801-5805 | 2007-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689218273 | Dymond Homes LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4223 S Prairie Ave, Chicago, IL 60653-3211 | 2019-11-06 |
| 1447782396 | Light of Hope | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 22858 Millard Ave, Richton Park, IL 60471-2531 | 2017-03-30 |
| 1760831945 | Nucare Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 18118 Orleans Dr, Hazel Crest, IL 60429-2242 | 2016-06-08 |
| 1649629346 | Catina Ballin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8808 Riley Road, Wonderlake, IL 60097 | 2016-06-03 |
| 1003262254 | Patterson House Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 717 E 1st South St, Carlinville, IL 62626-1922 | 2016-05-06 |
| 1235592288 | Ray Graham Association | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 901 Warrenville Rd, Suite 500, Lisle, IL 60532-4301 | 2016-03-29 |
| 1962867796 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1315 N Curran Rd, Mchenry, IL 60050-6520 | 2015-12-21 |
| 1942675228 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 N Hart St, Harvard, IL 60033-2227 | 2015-12-11 |
| 1518332881 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 851 W Main St, Cary, IL 60013-1920 | 2015-12-11 |
| 1083089361 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 455 Huntley Rd, Crystal Lake, IL 60014-5318 | 2015-12-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.