MIRACLE COMPREHENSIVE SERIVCES NPI 1417599945

NPI Information

  • NPI: 1417599945
  • Provider Name: MIRACLE COMPREHENSIVE SERIVCES
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Organization
  • Address: 4440 LINCOLN HWY STE 205
    MATTESON, IL
    ZIP 60443
  • Phone: (708) 769-1737

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NPI Details

MIRACLE COMPREHENSIVE SERIVCES is a community based residential treatment facility, intellectual and/or developmental disabilities in Matteson, IL. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. MIRACLE COMPREHENSIVE SERIVCES NPI is 1417599945. The provider is registered as an organization entity type.

The provider's business location address is:

4440 LINCOLN HWY STE 205
MATTESON, IL
ZIP 60443-803
Phone: (708) 769-1737

The provider's authorized official is Eme Udoetuk .
The authorized official title is Administrator and has the following contact phone number (708) 769-1737.

The enumeration date for this NPI number is 10/16/2019 and was last updated on 10/16/2019.

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
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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