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General NPI Number Information
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NPI Number | 1669662953
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Entity Type | Organization
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Legal Business Name | DIVERSIFIED URBAN CONSULTATION SYSTEMS INC
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 2008 S WABASH AVE SUITE 1
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City | CHICAGO
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State | IL
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Zip | 60616-1709
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Country | US
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Telephone | 312-203-2370
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Fax |
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Provider Business Mailing Address
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Address Line | 1130 S MICHIGAN AVE 1314
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City | CHICAGO
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State | IL
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Zip | 60605-2521
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Country | US
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Telephone | 312-203-2370
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Fax | 312-922-5368
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Authorized Official
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Title or Position | PRESIDENT
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Name | RONALD GORDON
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Credential |
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Telephone | 312-203-2370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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