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NPI Code Detail

MEDICARE: ASSOCIATION FOR INDIVIDUAL DEVELOPMENT

MEDICARE: ASSOCIATION FOR INDIVIDUAL DEVELOPMENT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)A-0400-003-AIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316199433
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASSOCIATION FOR INDIVIDUAL DEVELOPMENT
Provider Business Mailing Address
First Line : 309 W. NEW INDIAN TRAIL COURT
Second Line :
City : AURORA
State : IL
Zip : 60506-2494
Country : US
Telephone Number : 630-966-4000
Fax Number :
Provider Business Practice Location Address
First Line : 1230 N HIGHLAND AVE
Second Line :
City : AURORA
State : IL
Zip : 60506-1401
Country : US
Telephone Number : 630-966-4300
Fax Number : 630-859-2994
Authorized Official
Title or Position : PRESIDENT
Name : FRANCES L. BAKER
Credential :
Telephone Number : 630-966-4001
Provider Enumeration Date : 10/21/2008
Last Update Date : 03/14/2019

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1467628214 — MS. MICHELLE MARIE MCMULLIN L.C.P.C.
Practice Location Address:
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1245482355 — ASSOCIATION FOR INDIVIDUAL DEVELOPMENT
Practice Location Address:
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1952627192 — MS. ROSALIE P DEYOUNG MA, LCPC
Practice Location Address:
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Directions to “ASSOCIATION FOR INDIVIDUAL DEVELOPMENT ” Practice Location

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