ANN KILEY DEVELOPMENTAL CENTER
NPI 1679639967
Intermediate Care Facility, Intellectual Disabilities in Waukegan, IL

Q: What is the provider's specialty?

The provider's specialty is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Active since December 29, 2006

1401 W DUGDALE RD, WAUKEGAN, IL 60085(847) 249-0600(847) 249-0967 Get Directions Write a Review

NPPES record last updated: December 22, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Ann Kiley Developmental Center NPPES

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

ANN KILEY DEVELOPMENTAL CENTER (NPI 1679639967) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Waukegan, Illinois and active in the NPI registry since December 2006. The organization lists Debra Muhlstadt, Fiscal Administrator, Sodc Operatio, as its authorized official.

NPPES Registry Identity

NPI1679639967

Entity TypeOrganization

Primary Taxonomy315P00000X

Legal Business NameILLINOIS DEPARTMENT OF HUMAN SEVICES

Location Address1401 W DUGDALE RDWaukegan, IL 60085

Mailing Address3649 Whirlaway DrNorthbrook, IL 60062 · (847) 509-1254 · Fax (847) 509-1255

Phone(847) 249-0600

Fax(847) 249-0967

Organization SubpartYesParent: Illinois Department Of Human Services

Authorized OfficialDebra MuhlstadtFiscal Administrator, Sodc Operatio · (815) 288-8335

Enumeration DateDecember 29, 2006

Last NPPES UpdateDecember 22, 2016

✔ NPI 1679639967 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 · Developmental DisabilitiesTaxonomy 261QD1600X · License 036067892 (IL)

1401 W DUGDALE RD, Waukegan, IL 60085

Open in Google Maps ↗

Other Names 1

Other NameAnn Kiley Developmental Center

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 14D0726123

Illinois Dermatology Institute · Northbrook, IL

Expired · Jul 24, 2026

CLIA Number14D0726123

Laboratory TypePhysician Office

Certificate Effective DateJuly 25, 2024

Certificate Expiration DateJuly 24, 2026

Laboratory DirectorEvan Stokar

Laboratory Phone(847) 559-0090

Laboratory LocationIllinois Dermatology Institute1200 Shermer Rd Ste 200, Northbrook, IL 60062

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 14D2249050

Illinios Tech Labs Inc · Northbrook, IL

Expired · Jan 17, 2026

CLIA Number14D2249050

Laboratory TypeIndependent

Certificate Effective DateJanuary 18, 2024

Certificate Expiration DateJanuary 17, 2026

Laboratory DirectorShafeeq Khaja

Laboratory Phone(323) 681-3033

Laboratory LocationIllinios Tech Labs Inc1818 Skokie Blvd, Northbrook, IL 60062

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

PRATIBHA KATYAL MALHOTRA

Pediatrics