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NPI 1336008697 · Intellectual Disabilities Intermediate Care Facility · Chicago, IL
Provider details
- NPI number
- 1336008697
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Kevin Knoll, Secretary/General Counsel(773) 273-2729
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in 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
6300 N Ridge Ave
Chicago, IL 60660-1099
Phone: (773) 973-6300
Street-level locationGet directions
Mailing address
6300 N Ridge Ave
Chicago, IL 60660-1099
Registry dates
- Enumerated
- 2026-01-21
- Last updated
- 2026-01-21
- Certified
- 2026-01-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.