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General NPI Number Information
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NPI Number | 1083759534
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Entity Type | Organization
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Legal Business Name | DEPAUL FAMILY & COMMUNITY SERVICES
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 2247 N HALSTED ST RM 100
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City | CHICAGO
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State | IL
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Zip | 60614-6585
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Country | US
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Telephone | 773-325-7780
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Fax |
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Provider Business Mailing Address
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Address Line | 2247 N HALSTED ST RM 100
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City | CHICAGO
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State | IL
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Zip | 60614-6585
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Country | US
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Telephone | 773-325-7780
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Fax | 773-325-7781
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Authorized Official
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Title or Position | DIRECTOR
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Name | JULIE D BROSNAN
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Credential | PSY.D.
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Telephone | 773-325-7780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | IL
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