MEDICARE: KANKAKEE AUTISM CARE THERAPY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	235Z00000X	Speech-Language Pathologist
2	261QM0850X	Adult Mental Health Clinic/Center
3	225X00000X	Occupational Therapist
4	2355S0801X	Speech-Language Assistant
5	224Z00000X	Occupational Therapy Assistant
6	261QM0855X	Adolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number	:	1740154855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KANKAKEE AUTISM CARE THERAPY

Provider Business Mailing Address
First Line	:	35334 WASHINGTON ST
Second Line	:
City	:	CUSTER PARK
State	:	IL
Zip	:	60481-9157
Country	:	US
Telephone Number	:	815-272-6478
Fax Number	:

Provider Business Practice Location Address
First Line	:	249 S SCHUYLER AVE FL 2
Second Line	:
City	:	KANKAKEE
State	:	IL
Zip	:	60901-3884
Country	:	US
Telephone Number	:	815-272-6478
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KELLY FINNEGAN
Credential	:
Telephone Number	:	815-272-6478

Provider Enumeration Date	:	10/01/2025
Last Update Date	:	01/22/2026

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Directions to “KANKAKEE AUTISM CARE THERAPY ” Practice Location

Language	Start Address	Practice Location

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