Healthcare Provider Details

I. General information

NPI: 1184330540
Provider Name (Legal Business Name): FAMILY RESOURCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2023
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5828 N CLARK ST
CHICAGO IL
60660-4075
US

IV. Provider business mailing address

5828 N CLARK ST
CHICAGO IL
60660-4075
US

V. Phone/Fax

Practice location:
  • Phone: 773-321-0300
  • Fax: 773-321-0300
Mailing address:
  • Phone: 773-334-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TERESA BERNU
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW
Phone: 773-334-2300