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General NPI Number Information
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NPI Number | 1073155958
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Entity Type | Organization
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Legal Business Name | CHICAGO HEALTH CLINIC NFP
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Dates
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Enumeration Date | 10/12/2019
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Last Update Date | 10/12/2019
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Provider Practice Location Address
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Address Line | 6423 N ROCKWELL ST
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City | CHICAGO
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State | IL
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Zip | 60645-5319
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Country | US
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Telephone | 773-544-0201
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Fax |
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Provider Business Mailing Address
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Address Line | 6423 N ROCKWELL ST
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City | CHICAGO
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State | IL
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Zip | 60645-5319
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Country | US
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Telephone | 773-544-0201
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Fax |
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Authorized Official
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Title or Position | CHIEF LEGAL COUNSEL
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Name | MR. CHARLES LEVY
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Credential | ATTY
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Telephone | 773-544-0201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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