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NPI Code Detail

MEDICARE: I AM ABLE CENTER FOR FAMILY DEVELOPMENT

MEDICARE: I AM ABLE CENTER FOR FAMILY DEVELOPMENT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386062214
Entity Type Code : Organization
Provider Name (Legal Business Name) : I AM ABLE CENTER FOR FAMILY DEVELOPMENT
Provider Business Mailing Address
First Line : 3408 W ROOSEVELT RD
Second Line :
City : CHICAGO
State : IL
Zip : 60624-4338
Country : US
Telephone Number : 773-826-2929
Fax Number : 773-826-2966
Provider Business Practice Location Address
First Line : 3408 W ROOSEVELT RD
Second Line :
City : CHICAGO
State : IL
Zip : 60624-4338
Country : US
Telephone Number : 773-826-2929
Fax Number : 773-826-2966
Authorized Official
Title or Position : CEO/PRESIDENT
Name : DR. CAROLYN L VESSEL
Credential :
Telephone Number : 773-826-2929
Provider Enumeration Date : 03/28/2014
Last Update Date : 09/14/2020

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1760126833 — CHRISTIAN A. POLLARD
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1538891791 — KAREN B CASTLEBERRY
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CHICAGO, IL
60624-4338
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Practice Fax:
1992437024 — MR. ROBERT J CALHOUN SR.
Practice Location Address:
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60624-4338
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1083327167 — RODNEY ARMSTEAD
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Directions to “I AM ABLE CENTER FOR FAMILY DEVELOPMENT ” Practice Location

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