Healthcare Provider Details

I. General information

NPI: 1154252948
Provider Name (Legal Business Name): PEER SUPPORT ILLINOIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 S ASHLAND AVE APT 1
CHICAGO IL
60620-4242
US

IV. Provider business mailing address

7720 S ASHLAND AVE APT 1
CHICAGO IL
60620-4242
US

V. Phone/Fax

Practice location:
  • Phone: 844-733-7411
  • Fax:
Mailing address:
  • Phone: 844-733-7411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER BROWN
Title or Position: CEO
Credential: CRSS
Phone: 844-733-7411