Healthcare Provider Details

I. General information

NPI: 1548382690
Provider Name (Legal Business Name): ASIAN HUMAN SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424 W PETERSON AVE
CHICAGO IL
60659-4100
US

IV. Provider business mailing address

2838 W PETERSON AVE
CHICAGO IL
60659-3809
US

V. Phone/Fax

Practice location:
  • Phone: 773-293-8430
  • Fax: 773-728-4751
Mailing address:
  • Phone: 773-564-4944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberA50030001A
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: CATHRYN SAVINO
Title or Position: DIRECTOR, BEHAVIORAL HEALTH
Credential: LCPC
Phone: 480-620-9762