OrganizationActive
Supported Independence
NPI 1649548405 · Community/Behavioral Health Agency · Hazel Crest, IL
Provider details
- NPI number
- 1649548405
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Jessica Luckett, President(630) 667-7370
Specialties & taxonomies
Agencies
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 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
17009 Elm Drive
Hazel Crest, IL 60429
Phone: (630) 667-7370
Street-level locationGet directions
Mailing address
17900 Elm Drive
Hazel Crest, IL 60429
Registry dates
- Enumerated
- 2011-12-08
- Last updated
- 2011-12-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.