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General NPI Number Information
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NPI Number | 1215282926
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Entity Type | Organization
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Legal Business Name | CATHOLIC CHARITIES OF THE ARCHDIOCESE OF CHICAGO
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 721 N LASALLE ST 5TH FLOOR
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City | CHICAGO
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State | IL
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Zip | 60610
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Country | US
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Telephone | 312-948-7412
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Fax | 312-640-1587
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Provider Business Mailing Address
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Address Line | 721 N LASALLE ST 5TH FLOOR
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City | CHICAGO
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State | IL
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Zip | 60610
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Country | US
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Telephone | 312-948-7412
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Fax | 312-640-1587
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MS. KRISTEN KOEPPE
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Credential |
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Telephone | 773-630-4690
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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 |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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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 | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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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 | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State | IL
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