Healthcare Provider Details

I. General information

NPI: 1356263099
Provider Name (Legal Business Name): CATHOLIC CHARITIES OF THE ARCHDIOCESE OF CHICAGO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 W MARQUETTE RD
CHICAGO IL
60629-1817
US

IV. Provider business mailing address

721 N LASALLE DRIVE
CHICAGO IL
60654
US

V. Phone/Fax

Practice location:
  • Phone: 312-655-7700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ELLEN TANNENBAUM
Title or Position: DIRECTOR - BEHAVIORAL HEALTH
Credential:
Phone: 773-551-3067