Healthcare Provider Details

I. General information

NPI: 1730580523
Provider Name (Legal Business Name): THE CHILDREN'S PLACE ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2014
Last Update Date: 09/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3059 W AUGUSTA BLVD
CHICAGO IL
60622-4314
US

IV. Provider business mailing address

700 N SACRAMENTO BLVD SUITE 300
CHICAGO IL
60612-1046
US

V. Phone/Fax

Practice location:
  • Phone: 773-826-1230
  • Fax: 773-826-0705
Mailing address:
  • Phone: 312-733-9954
  • Fax: 312-243-7653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. CATHY KRIEGER
Title or Position: PRESIDENT & CEO
Credential:
Phone: 312-660-3020