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NPI Code Detail

MEDICARE: DEPAUL FAMILY & COMMUNITY SERVICES

MEDICARE: DEPAUL FAMILY & COMMUNITY SERVICES
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)

General Provider Information

NPI Number : 1629246467
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEPAUL FAMILY & COMMUNITY SERVICES
Provider Business Mailing Address
First Line : 2156 W WELLINGTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-8156
Country : US
Telephone Number : 773-477-5581
Fax Number :
Provider Business Practice Location Address
First Line : 2156 W WELLINGTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-8156
Country : US
Telephone Number : 773-477-5581
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MS. SHEILA C. RIBORDY
Credential : PH.D.
Telephone Number : 773-325-7780
Provider Enumeration Date : 02/14/2008
Last Update Date : 07/25/2008

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Directions to “DEPAUL FAMILY & COMMUNITY SERVICES ” Practice Location

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