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NPI 1992668776

NPI 1992668776 : ESPERANZA COMMUNITY SERVICES : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1992668776
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    Entity Type          |    Organization 
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    Legal Business Name  |    ESPERANZA COMMUNITY SERVICES 
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Dates
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    Enumeration Date     |    12/08/2025
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    Last Update Date     |    12/08/2025
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Provider Practice Location Address
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    Address Line         |    520 N MARSHFIELD AVE 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60622-6731
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    Country              |    US
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    Telephone            |    312-243-6097
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    Fax                  |    312-243-2076
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Provider Business Mailing Address
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    Address Line         |    520 N MARSHFIELD AVE 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60622-6731
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    Country              |    US
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    Telephone            |    312-243-6097
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    Fax                  |    312-243-2076
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |    MS. JAYNE M DREW 
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    Credential           |    
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    Telephone            |    312-243-6097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0855X
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    Taxonomy Name        |    Adolescent and Children Mental Health Clinic/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        |    261QM0850X
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    Taxonomy Name        |    Adult Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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