Provider Demographics
NPI:1972553709
Name:SPECIAL CHILDREN, INC.
Entity Type:Organization
Organization Name:SPECIAL CHILDREN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-234-6876
Mailing Address - Street 1:1306 WABASH AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-3370
Mailing Address - Country:US
Mailing Address - Phone:618-234-6876
Mailing Address - Fax:618-234-6150
Practice Address - Street 1:1306 WABASH AVE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-3370
Practice Address - Country:US
Practice Address - Phone:618-234-6876
Practice Address - Fax:618-234-6150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
252Y00000X
IL225100000X, 225100000X, 235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL321648226001Medicaid
IL347721087001Medicaid
IL495608727001Medicaid
IL321502460001Medicaid