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General NPI Number Information
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NPI Number | 1316790694
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Entity Type | Organization
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Legal Business Name | NORTHWESTERN UNIVERSITY SETTLEMENT ASSOCIATION
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 1420 W AUGUSTA BLVD
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City | CHICAGO
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State | IL
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Zip | 60642-3939
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Country | US
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Telephone | 773-278-7471
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Fax | 855-273-4414
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Provider Business Mailing Address
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Address Line | 1012 N NOBLE ST
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City | CHICAGO
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State | IL
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Zip | 60642-4011
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Country | US
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Telephone | 773-278-7471
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Fax | 855-273-4414
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Authorized Official
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Title or Position | VICE PRESIDENT OF FAMILY CARES
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Name | BRYAN HEIDEL
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Credential | LCPC
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Telephone | 773-569-9553
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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 |
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