MEDICARE: HUMAN RESOURCES DEVELOPMENT INSTITUTE, INC.

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
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1528246865
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUMAN RESOURCES DEVELOPMENT INSTITUTE, INC.

Provider Business Mailing Address
First Line	:	222 S JEFFERSON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60661-5603
Country	:	US
Telephone Number	:	312-441-9009
Fax Number	:	312-441-9019

Provider Business Practice Location Address
First Line	:	2311 E 98TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-4842
Country	:	US
Telephone Number	:	773-785-4955
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF CONTRACT ADMINISTRATION
Name	:	MS. RENZY RICHARDSON
Credential	:
Telephone Number	:	312-441-9009

Provider Enumeration Date	:	02/08/2008
Last Update Date	:	08/12/2020

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