JACK MABLEY DEVELOPMENTAL CENTER
NPI 1376525204
Intermediate Care Facility, Intellectual Disabilities in Dixon, IL
About Jack Mabley Developmental Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACK MABLEY DEVELOPMENTAL CENTER (NPI 1376525204) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Dixon, Illinois and active in the NPI registry since November 2005. The organization lists Debra Muhlstadt, Fiscal Administrator, Sodc Operatio, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 4
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jack Mabley Developmental Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
45Medicare enrollment records show 45 clinicians reassign Medicare billing to Jack Mabley Developmental Center, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 11
Nearest to this location (20)
See all 45Maywood, IL 60153
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Illinois Department Of Human Services's NPI number?
The NPI number for Illinois Department Of Human Services is 1376525204. It was assigned to this organization in the NPPES registry on November 16, 2005. The provider is also known as Jack Mabley Developmental Center.
Where is Illinois Department Of Human Services located?
Illinois Department Of Human Services is located at 1120 Washington Ave, Dixon, IL 61021. The listed phone number is (815) 288-8301.
What is Illinois Department Of Human Services's specialty?
The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.
Is Illinois Department Of Human Services enrolled in Medicare?
Yes. Illinois Department Of Human Services is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Illinois Department Of Human Services?
According to the CMS Revalidation Reassignment List (October 2026 release), 45 clinicians in 11 Medicare specialties reassign their Medicare billing to Illinois Department Of Human Services. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (13), Psychiatry (12) and Family Practice (5). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Illinois Department Of Human Services was last updated on December 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Jack Mabley Developmental Center · NPI 1376525204
Intermediate Care Facility, Intellectual Disabilities organization in Dixon, Illinois. Organization record, active in the CMS NPPES registry since November 16, 2005.
## Identity
- **NPI:** 1376525204 (Entity type: Organization)
- **Enumerated:** November 16, 2005
- **Primary specialty:** Intermediate Care Facility, Intellectual Disabilities · taxonomy 315P00000X
- **Legal business name:** Illinois Department Of Human Services
- **Organization subpart:** No
- **Authorized official:** Debra Muhlstadt, FISCAL ADMINISTRATOR, SODC OPERATIO
## Practice location
- **Address:** 1120 WASHINGTON AVE, Dixon, IL 61021-1258
- **Phone:** (815) 288-8301 · **Fax:** (815) 288-8398
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 45 clinicians in 11 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (13), Psychiatry (12), Family Practice (5); 1 practice within 10 miles; [full list](https://npiprofile.com/npi/1376525204/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 22, 2016
- **Other identifiers:** Medicare UPIN E63807 (IL); Medicare UPIN 830600 (IL); Medicare UPIN T38623 (IL); and 1 more
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Source: [NPI Profile](https://npiprofile.com/npi/1376525204) · Data from the CMS NPPES public registry.