Healthcare Provider Details

I. General information

NPI: 1598551095
Provider Name (Legal Business Name): HISPANIC THERAPEUTIC SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2025
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5719 W FULLERTON AVE APT 1F
CHICAGO IL
60639-2337
US

IV. Provider business mailing address

5719 W FULLERTON AVE APT 1F
CHICAGO IL
60639-2337
US

V. Phone/Fax

Practice location:
  • Phone: 773-865-2384
  • Fax:
Mailing address:
  • Phone: 773-865-2384
  • Fax: 224-331-8014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: NORMA MARTINEZ
Title or Position: PRESIDENT
Credential: LSW
Phone: 773-865-2384