Healthcare Provider Details

I. General information

NPI: 1184680175
Provider Name (Legal Business Name): E.R.I.C. FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6120 W NORTH AVE STE 202
CHICAGO IL
60639-3901
US

IV. Provider business mailing address

6120 W NORTH AVE STE 202
CHICAGO IL
60639-3901
US

V. Phone/Fax

Practice location:
  • Phone: 773-745-3742
  • Fax: 773-754-0655
Mailing address:
  • Phone: 773-745-3742
  • Fax: 773-754-0655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number244670
License Number StateIL

VIII. Authorized Official

Name: DR. SHEILA C. CURREN
Title or Position: EXECUTIVE DIRECTOR
Credential: PH.D., LCSW
Phone: 773-745-3742