Healthcare Provider Details

I. General information

NPI: 1891001186
Provider Name (Legal Business Name): CITY OF CHICAGO DEP. OF PUBLIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2010
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 N PULASKI RD
CHICAGO IL
60646-6007
US

IV. Provider business mailing address

5801 N PULASKI RD
CHICAGO IL
60646-6007
US

V. Phone/Fax

Practice location:
  • Phone: 312-744-1906
  • Fax: 312-744-5568
Mailing address:
  • Phone: 312-744-1906
  • Fax: 312-744-5568

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: MS. JOYCE MORRIS
Title or Position: PROJECTS ADMINISTRATOR
Credential:
Phone: 312-747-9545