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NPI Code Detail

MEDICARE: UCP SEGUIN OF GREATER CHICAGO

MEDICARE: UCP SEGUIN OF GREATER CHICAGO
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
1251C00000XDevelopmentally Disabled Services Day Training Agency
2253J00000XFoster Care Agency
3253Z00000XIn Home Supportive Care Agency
4261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1649404716
Entity Type Code : Organization
Provider Name (Legal Business Name) : UCP SEGUIN OF GREATER CHICAGO
Provider Business Mailing Address
First Line : 3100 S CENTRAL AVE
Second Line :
City : CICERO
State : IL
Zip : 60804-3956
Country : US
Telephone Number : 708-222-4248
Fax Number : 708-222-0478
Provider Business Practice Location Address
First Line : 3100 S CENTRAL AVE
Second Line :
City : CICERO
State : IL
Zip : 60804-3956
Country : US
Telephone Number : 708-222-4248
Fax Number : 708-222-0478
Authorized Official
Title or Position : SENIOR VICE PRESIDENT
Name : MR. THOMAS LEONARD FOLEY
Credential :
Telephone Number : 708-222-4248
Provider Enumeration Date : 05/05/2009
Last Update Date : 06/13/2023

Similar Medicare Providers

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Practice Location Address:
3100 S CENTRAL AVE
CICERO, IL
60804-3956
Practice Phone: 708-863-3803
Practice Fax:
1083428437 — DANIELLE ANTOINETTE PATTERSON
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3100 S CENTRAL AVE
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60804-3956
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Practice Fax:
1023267358 — SEGUIN SERVICES
Practice Location Address:
3100 S CENTRAL AVE
CICERO, IL
60804-3956
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Practice Fax:
1851668164 — NATALIE C DIAZ
Practice Location Address:
3100 S CENTRAL AVE
CICERO, IL
60804-3956
Practice Phone: 708-863-3803
Practice Fax:
1487910998 — DANA PAVLIK BCBA
Practice Location Address:
3100 S CENTRAL AVE
CICERO, IL
60804-3956
Practice Phone: 708-863-3803
Practice Fax:
1053740597 — MS. DONNA LYNN RESSLER ROBINSON
Practice Location Address:
3100 S CENTRAL AVE
CICERO, IL
60804-3956
Practice Phone: 708-863-3803
Practice Fax: 708-222-0852

Directions to “UCP SEGUIN OF GREATER CHICAGO ” Practice Location

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