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

NPI Status: Active since December 29, 2006

Contact Information

1401 W DUGDALE RD
WAUKEGAN, IL
ZIP 60085
Phone: (847) 249-0600
Fax: (847) 249-0967

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Intermediate Care Facility, Intellectual...
CLIA Number: 14D2249050
CLIA Cert. Type: Independent
CLIA Exp. Date: 01-17-2026

About ANN KILEY DEVELOPMENTAL CENTER

This page provides the complete NPI Profile along with additional information for Ann Kiley Developmental Center, a provider established in Waukegan, Illinois operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1679639967 assigned on December 2006. The practitioner's primary taxonomy code is 315P00000X. The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's other name is Ann Kiley Developmental Center. The authorized official of this NPI record is Debra Muhlstadt (Fiscal Administrator, Sodc Operatio)

NPI: 1679639967
Provider Legal Name: ILLINOIS DEPARTMENT OF HUMAN SEVICES
Other Organization Name: ANN KILEY DEVELOPMENTAL CENTER
Other Name Type: Other Name (5)
Entity Type: Organization
Location Address: 1401 W DUGDALE RD WAUKEGAN, IL 60085
Location Phone: (847) 249-0600
Location Fax: (847) 249-0967
Mailing Address: 3649 WHIRLAWAY DR NORTHBROOK, IL 60062
Mailing Phone: (847) 509-1254
Mailing Fax: (847) 249-0967
Is Sole Proprietor?: No
Is Organization Subpart?: Yes
Enumeration Date: 12-29-2006
Last Update Date: 12-22-2016
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Intermediate Care Facility, Intellectual Disabilities
Taxonomy Code: 315P00000X
Type: Nursing & Custodial Care Facilities
Taxonomy Description: An intermediate care facility providing services for individuals with intellectual disabilities.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	261QD1600X	Ambulatory Health Care Facilities	Clinic/Center Developmental Disabilities	036067892 (IL)

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: DEBRA MUHLSTADT
Authorized Official Title: FISCAL ADMINISTRATOR, SODC OPERATIO
Authorized Official Phone: (815) 288-8335

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 14D2249050
Facility Type: Independent
Certificate Effective Date: January 18, 2024
Certificate Expiration Date: January 17, 2026
Laboratory Director: SHAFEEQ KHAJA
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Ann Kiley Developmental Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1679639967, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 14 → 1 + 4

Pos 4

Unchanged

Pos 5

Doubled → 12 → 1 + 2

Pos 6

Unchanged

Pos 7

Doubled → 18 → 1 + 8

Pos 8

Unchanged

Pos 9

Doubled → 12 → 1 + 2

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 6 → 12 → 3 9 → 18 → 9 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 4 + 9 + 1 + 2 + 3 + 1 + 8 + 9 + 1 + 2 + 24 = 73

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 73 is 80. The difference is the calculated check digit.

80 - 73 = 7

This NPI is valid

The calculated check digit is 7, which matches the last digit of 1679639967.