Healthcare Provider Details

I. General information

NPI: 1497288096
Provider Name (Legal Business Name): VOLUNTEERS OF AMERICA OF ILLINOIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 09/30/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 W POLK ST SUITE 250
CHICAGO IL
60605-2000
US

IV. Provider business mailing address

47 W POLK ST SUITE 250
CHICAGO IL
60605-2000
US

V. Phone/Fax

Practice location:
  • Phone: 312-564-2300
  • Fax: 312-564-2301
Mailing address:
  • Phone: 312-564-2300
  • Fax: 312-564-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number021329
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NANCY HUGHES MOYER
Title or Position: PRESIDENT & CEO
Credential: MSW
Phone: 312-564-2310