OrganizationActive
Laureate Kankakee Operations LLC
NPI 1205488954 · Mental Illness Intermediate Care Facility · Bourbonnais, IL
Provider details
- NPI number
- 1205488954
- Entity type
- Organization
- Primary specialty
- Mental Illness Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Shaun Ahmad, Manager(704) 426-8849
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
100 Belle Aire Ave
Bourbonnais, IL 60914-2006
Phone: (815) 939-0910
Fax: (815) 929-0973
Street-level locationGet directions
Mailing address
13024 Balntyn Corp Pl Ste 425
Charlotte, NC 28277-4420
Registry dates
- Enumerated
- 2019-07-12
- Last updated
- 2019-07-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.