Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 251V00000X | Voluntary or Charitable | | | | No |
| 2 | 261QA0600X | Clinic/Center | Adult Day Care | | ILLINOIS | No |
| 3 | 261QD1600X | Clinic/Center | Developmental Disabilities | | ILLINOIS | No |
| 4 | 261QH0700X | Clinic/Center | Hearing and Speech | | ILLINOIS | No |
| 5 | 261QP2000X | Clinic/Center | Physical Therapy | | ILLINOIS | No |
| 6 | 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | ILLINOIS | No |
| 7 | 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | | | ILLINOIS | No |
| 8 | 315P00000X | Intermediate Care Facility, Intellectual Disabilities | | 000028324 | ILLINOIS | No |
| 9 | 251C00000X | Day Training, Developmentally Disabled Services | | 0408 | ILLINOIS | No |
| 10 | 225X00000X | Occupational Therapist | | | | No |
| 11 | 235Z00000X | Speech-Language Pathologist | | | | No |
| 12 | 225100000X | Physical Therapist | | | | No |
| 13 | 251C00000X | Day Training, Developmentally Disabled Services | | | ILLINOIS | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | IL3516 | MEDICARE UPIN | ILLINOIS | |
