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NPI Code Detail

MEDICARE: ENVISION UNLIMITED FOSTER CARE PROGRAM

MEDICARE: ENVISION UNLIMITED FOSTER CARE PROGRAM
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
1253J00000XFoster Care Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1004181OTHERILDEPARTMENT OF CHILDREN AND FAMILY SERVICES

General Provider Information

NPI Number : 1336440619
Entity Type Code : Organization
Provider Name (Legal Business Name) : ENVISION UNLIMITED FOSTER CARE PROGRAM
Provider Business Mailing Address
First Line : 5333 S GREENWOOD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60615-4303
Country : US
Telephone Number : 773-241-5700
Fax Number : 773-241-5702
Provider Business Practice Location Address
First Line : 5333 S GREENWOOD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60615-4303
Country : US
Telephone Number : 773-241-5700
Fax Number : 773-241-5702
Authorized Official
Title or Position : PRESIDENT CEO
Name : MS. KRISTIN V MACRAE
Credential :
Telephone Number : 312-346-6230
Provider Enumeration Date : 11/03/2010
Last Update Date : 11/03/2010

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Directions to “ENVISION UNLIMITED FOSTER CARE PROGRAM ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.