PROVIDENCE CENTER
NPI 1417305897
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Chicago, IL

Q: What is Providence Center's NPI number?

The NPI number for Providence Center is 1417305897. It was assigned to this organization in the NPPES registry on May 26, 2016.

Q: What is Providence Center's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

Q: When was this NPI record last updated?

The NPPES record for Providence Center was last updated on May 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since May 26, 2016

4200 N AUSTIN AVE, CHICAGO, IL 60634(773) 545-8300 Get Directions Write a Review

NPPES record last updated: May 26, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Providence Center NPPES

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

PROVIDENCE CENTER (NPI 1417305897) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Chicago, Illinois and active in the NPI registry since May 2016. The organization lists Charleen M. Badiola, Director, as its authorized official.

NPPES Registry Identity

NPI1417305897

Entity TypeOrganization

Primary Taxonomy320900000X

Legal Business NamePROVIDENCE CENTER

Location Address4200 N AUSTIN AVEChicago, IL 60634-1615

Mailing Address4200 N Austin AveChicago, IL 60634-1615 · (773) 545-8300

Phone(773) 545-8300

Organization SubpartYesParent: St. Mary Of Providence

Authorized OfficialCharleen M. BadiolaDirector · (773) 545-8300

Enumeration DateMay 26, 2016

✔ NPI 1417305897 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities

Taxonomy Code320900000X

License✔ Licensed in IL · 2000404

Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

4200 N AUSTIN AVE, Chicago, IL 60634

Open in Google Maps ↗

Other Identifiers 1

Medicaid14G191IL

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ST. MARY OF PROVIDENCE DEVELOPMENTAL TRAINING PROGRAM

Day Training, Developmentally Disabled Services

4200 N AUSTIN AVE
CHICAGO, IL 60634

Cook County (773) 545-8300

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 Providence Center's NPI number?

The NPI number for Providence Center is 1417305897. It was assigned to this organization in the NPPES registry on May 26, 2016.

Where is Providence Center located?

Providence Center is located at 4200 N Austin Ave, Chicago, IL 60634. The listed phone number is (773) 545-8300.

What is Providence Center's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Providence Center was last updated on May 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.