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General NPI Number Information
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NPI Number | 1144550948
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Entity Type | Organization
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Legal Business Name | KALEIDOSCOPE INC.
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Dates
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Enumeration Date | 12/30/2009
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 1901 W CARROLL AVE STE 205
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City | CHICAGO
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State | IL
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Zip | 60612-2401
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Country | US
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Telephone | 773-278-7200
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Fax | 773-278-5663
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Provider Business Mailing Address
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Address Line | 1901 W CARROLL AVE STE 205
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City | CHICAGO
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State | IL
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Zip | 60612-2401
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Country | US
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Telephone | 773-278-7200
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Fax | 773-278-5663
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KATHY JEAN GRZELAK
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Credential |
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Telephone | 773-292-4076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 011126-13
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | 011126-13
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License Number State | IL
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Taxonomy #3
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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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