Healthcare Provider Details

I. General information

NPI: 1740154855
Provider Name (Legal Business Name): KANKAKEE AUTISM CARE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 S SCHUYLER AVE FL 2
KANKAKEE IL
60901-3884
US

IV. Provider business mailing address

35334 WASHINGTON ST
CUSTER PARK IL
60481-9157
US

V. Phone/Fax

Practice location:
  • Phone: 815-272-6478
  • Fax:
Mailing address:
  • Phone: 815-272-6478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KELLY FINNEGAN
Title or Position: OWNER
Credential:
Phone: 815-272-6478