MEDICARE: SHADES OF HOPE LLC

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
1	261QM0850X	Adult Mental Health Clinic/Center
2	251S00000X	Community/Behavioral Health Agency	149.015481	IL
3	261QM0855X	Adolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number	:	1619301066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHADES OF HOPE LLC

Provider Business Mailing Address
First Line	:	10540 S WESTERN AVE STE 208
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-2529
Country	:	US
Telephone Number	:	872-400-6113
Fax Number	:	866-903-0238

Provider Business Practice Location Address
First Line	:	10540 S WESTERN AVE STE 208
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-2529
Country	:	US
Telephone Number	:	872-400-6113
Fax Number	:	866-903-0238

Authorized Official
Title or Position	:	CEO
Name	:	AKILAH BAKER
Credential	:	LCSW
Telephone Number	:	872-400-6113

Provider Enumeration Date	:	08/21/2013
Last Update Date	:	04/23/2026

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Directions to “SHADES OF HOPE LLC ” Practice Location

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