Healthcare Provider Details

I. General information

NPI: 1497661383
Provider Name (Legal Business Name): ASSOCIATION FOR INDIVIDUAL DEVELOPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 WASHINGTON ST
WEST DUNDEE IL
60118-1245
US

IV. Provider business mailing address

309 NEW INDIAN TRAIL CT
AURORA IL
60506-2411
US

V. Phone/Fax

Practice location:
  • Phone: 630-720-2124
  • Fax: 224-769-7210
Mailing address:
  • Phone: 630-966-4000
  • Fax: 630-844-2065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KELLY HOELSCHER
Title or Position: BILLING ADMINISTRATOR
Credential:
Phone: 630-966-4041