Healthcare Provider Details

I. General information

NPI: 1861318578
Provider Name (Legal Business Name): SECOND SEASON ADULT DAY RETREAT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 IL ROUTE 22
FOX RIVER GROVE IL
60021-1905
US

IV. Provider business mailing address

906 IL ROUTE 22
FOX RIVER GROVE IL
60021-1905
US

V. Phone/Fax

Practice location:
  • Phone: 224-249-0032
  • Fax: 847-844-0672
Mailing address:
  • Phone: 224-249-0032
  • Fax: 847-844-0672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: IRIS M SANTIAGO
Title or Position: MANAGER
Credential:
Phone: 630-965-4446