Provider Demographics
NPI:1467430124
Name:ILLINOIS DEPARTMENT OF HUMAN SERVICES
Entity Type:Organization
Organization Name:ILLINOIS DEPARTMENT OF HUMAN SERVICES
Other - Org Name:ANDREW MCFARLAND MENTAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:QUALITY MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:DILELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-786-6916
Mailing Address - Street 1:901 SOUTHWIND DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62703-5125
Mailing Address - Country:US
Mailing Address - Phone:217-786-6994
Mailing Address - Fax:217-786-7167
Practice Address - Street 1:901 SOUTHWIND DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62703-5125
Practice Address - Country:US
Practice Address - Phone:217-786-6994
Practice Address - Fax:217-786-7167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL144021Medicare Oscar/Certification