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NPI Code Detail

MEDICARE: I AM ABLE CENTER FOR FAMILY DEVELOPMENT, INC.

MEDICARE: I AM ABLE CENTER FOR FAMILY DEVELOPMENT, 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1700894979
Entity Type Code : Organization
Provider Name (Legal Business Name) : I AM ABLE CENTER FOR FAMILY DEVELOPMENT, INC.
Provider Business Mailing Address
First Line : 3410 WEST ROOSEVELT ROAD
Second Line :
City : CHICAGO
State : IL
Zip : 60624-4343
Country : US
Telephone Number : 773-826-2929
Fax Number : 773-826-2964
Provider Business Practice Location Address
First Line : 3410 W ROOSEVELT RD
Second Line :
City : CHICAGO
State : IL
Zip : 60624-4343
Country : US
Telephone Number : 773-826-2929
Fax Number : 773-826-2964
Authorized Official
Title or Position : CEO/PRESIDENT
Name : DR. CAROLYN L. VESSEL
Credential : BA, MSHSA, M-DIV.,DD
Telephone Number : 773-840-8061
Provider Enumeration Date : 08/04/2006
Last Update Date : 09/14/2020

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