COUNTRY CLUB TERRACE
NPI 1154509289
Intermediate Care Facility, Intellectual Disabilities in Country Club Hills, IL

Q: What is St. Coletta's Of Illinois, Inc.'s NPI number?

The NPI number for St. Coletta's Of Illinois, Inc. is 1154509289. It was assigned to this organization in the NPPES registry on January 31, 2008. The provider is doing business as Country Club Terrace.

Q: What is St. Coletta's Of Illinois, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Active since January 31, 2008

4900 183RD ST, COUNTRY CLUB HILLS, IL 60478(708) 647-0752(708) 342-2579 Get Directions Write a Review

NPPES record last updated: March 31, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Country Club Terrace NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COUNTRY CLUB TERRACE (NPI 1154509289) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Country Club Hills, Illinois and active in the NPI registry since January 2008. The organization lists Annette Skafgaard, Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1154509289

Entity TypeOrganization

Primary Taxonomy315P00000X

Legal Business NameST. COLETTA'S OF ILLINOIS, INC.

Location Address4900 183RD STCountry Club Hills, IL 60478-4568

Mailing Address18350 Crossing DrTinley Park, IL 60487-6294 · (708) 342-5200 · Fax (708) 429-7021

Phone(708) 647-0752

Fax(708) 342-2579

Organization SubpartNo

Authorized OfficialAnnette SkafgaardDirector Of Finance · (708) 342-5253

Enumeration DateJanuary 31, 2008

Last NPPES UpdateMarch 31, 2022

NPPES CertifiedMarch 31, 2022

✔ NPI 1154509289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities

Taxonomy Code315P00000X

Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X

4900 183RD ST, Country Club Hills, IL 60478

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Other Names 1

Doing Business AsCountry Club Terrace

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St. Coletta's Of Illinois, Inc.'s NPI number?

The NPI number for St. Coletta's Of Illinois, Inc. is 1154509289. It was assigned to this organization in the NPPES registry on January 31, 2008. The provider is doing business as Country Club Terrace.

Where is St. Coletta's Of Illinois, Inc. located?

St. Coletta's Of Illinois, Inc. is located at 4900 183rd St, Country Club Hills, IL 60478. The listed phone number is (708) 647-0752.

What is St. Coletta's Of Illinois, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for St. Coletta's Of Illinois, Inc. was last updated on March 31, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.