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General NPI Number Information
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NPI Number | 1063302487
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Entity Type | Organization
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Legal Business Name | TABLE OF HOPE CHICAGO
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 1130 N HAMLIN AVE
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City | CHICAGO
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State | IL
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Zip | 60651-3841
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Country | US
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Telephone | 773-971-2319
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Fax |
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Provider Business Mailing Address
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Address Line | 1130 N HAMLIN AVE
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City | CHICAGO
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State | IL
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Zip | 60651-3841
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Country | US
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Telephone | 773-971-2319
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHANELL HAYES
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Credential |
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Telephone | 773-971-2319
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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