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General NPI Number Information
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NPI Number | 1932598893
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Entity Type | Organization
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Legal Business Name | ONE FAMILY ILLINOIS
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 10/05/2025
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Provider Practice Location Address
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Address Line | 1133 W 13TH ST
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City | CHICAGO
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State | IL
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Zip | 60608-1881
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Country | US
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Telephone | 312-243-1901
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Fax | 312-243-3086
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Provider Business Mailing Address
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Address Line | 216 W JACKSON BLVD STE 925
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City | CHICAGO
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State | IL
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Zip | 60606-6996
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Country | US
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Telephone | 312-372-8200
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Fax | 312-372-8202
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Authorized Official
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Title or Position | DIRECTOR OF BEHAVIORAL HEALTH
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Name | GLORIA MARIN COCKERILL
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Credential | LCSW
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Telephone | 312-243-1901
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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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Taxonomy #2
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | 198705
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License Number State | IL
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