IndividualActive
Adewole Adeleke
NPI 1508429242 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Country Club Hills, IL
Provider details
- NPI number
- 1508429242
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
18041 Thomas Ln
Country Club Hills, IL 60478-5065
Phone: (708) 914-4089
Approximate (ZIP-level) locationGet directions
Mailing address
3050 Bob O Link Rd
Flossmoor, IL 60422-1420
Registry dates
- Enumerated
- 2019-04-18
- Last updated
- 2024-08-30
- Certified
- 2024-08-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.