Healthcare Provider Details

I. General information

NPI: 1821387119
Provider Name (Legal Business Name): JEWISH CHILD AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3145 W PRATT BLVD
CHICAGO IL
60645-4125
US

IV. Provider business mailing address

3145 W PRATT BLVD
CHICAGO IL
60645-4125
US

V. Phone/Fax

Practice location:
  • Phone: 773-467-3700
  • 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
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VINCENT EVERSON
Title or Position: CFO
Credential:
Phone: 312-673-2714