Healthcare Provider Details

I. General information

NPI: 1699687772
Provider Name (Legal Business Name): THE BOULEVARD OF CHICAGO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3456 W FRANKLIN BLVD
CHICAGO IL
60624-1308
US

IV. Provider business mailing address

542 S DEARBORN ST FL 3
CHICAGO IL
60605-1508
US

V. Phone/Fax

Practice location:
  • Phone: 773-533-6013
  • Fax: 773-533-3930
Mailing address:
  • Phone: 773-533-6013
  • Fax: 773-533-3930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN RECCHIA
Title or Position: CHIEF PROGRAM OFFICER
Credential: LSW, MS
Phone: 773-666-4716