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General NPI Number Information
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NPI Number | 1497071187
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Entity Type | Organization
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Legal Business Name | CATHOLIC CHARITIES - DIOCESE OF ROCKFORD, IL.
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Dates
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Enumeration Date | 04/20/2010
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Last Update Date | 04/20/2010
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Provider Practice Location Address
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Address Line | 5141 BULL VALLEY RD
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City | MCHENRY
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State | IL
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Zip | 60050-7431
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Country | US
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Telephone | 815-344-6956
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Fax | 815-344-7869
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Provider Business Mailing Address
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Address Line | 555 COLMAN CENTER DR. - PO BOX 7044
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City | ROCKFORD
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State | IL
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Zip | 61125
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Country | US
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Telephone | 815-399-4300
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Fax | 814-399-6303
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Authorized Official
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Title or Position | DIOCESAN DIRECTOR
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Name | MR. FRANK VONCH
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Credential |
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Telephone | 815-399-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | 003972-12
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License Number State | IL
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