OrganizationActive
Providence Center
NPI 1417305897 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Chicago, IL
Provider details
- NPI number
- 1417305897
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Parent organization
- St. Mary of Providence
- Organization subpart
- Yes
- Authorized official
- Charleen Badiola, Director(773) 545-8300
- License
- 2000404 (IL)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 2000404 (IL)
Residential Treatment Facilities
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 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
4200 N Austin Ave
Chicago, IL 60634-1615
Phone: (773) 545-8300
Street-level locationGet directions
Mailing address
4200 N Austin Ave
Chicago, IL 60634-1615
Registry dates
- Enumerated
- 2016-05-26
- Last updated
- 2016-05-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.