MEDICARE: THRESHOLDS

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	251S00000X	Community/Behavioral Health Agency
2	251S00000X	Community/Behavioral Health Agency	04133	IL
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1780998781
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRESHOLDS

Provider Business Mailing Address
First Line	:	4101 N RAVENSWOOD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613
Country	:	US
Telephone Number	:	773-572-5500
Fax Number	:	773-271-2597

Provider Business Practice Location Address
First Line	:	2529 W FITCH AVE APT 106
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-3162
Country	:	US
Telephone Number	:	773-572-5500
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MR. AL SHOREIBAH
Credential	:
Telephone Number	:	773-572-5262

Provider Enumeration Date	:	08/02/2010
Last Update Date	:	01/16/2019

Similar Medicare Providers

1306951835 — HATTIE WEATHERS L.P.N
Practice Location Address:

625 N MICHIGAN AVE STE 210
CHICAGO, IL
60611-3162

Practice Phone: 312-670-2530
Practice Fax: 312-670-2630

1902310030 — MRS. ALYSSA C TOREN CNM
Practice Location Address:

625 N MICHIGAN AVE STE 210
CHICAGO, IL
60611-3162

Practice Phone: 312-670-2530
Practice Fax:

1194689976 — MRS. YIFAT MOSTOFSKY FNP-BC
Practice Location Address:

6833 N KEDZIE AVE APT 201
CHICAGO, IL
60645-2873

Practice Phone: 347-668-3968
Practice Fax:

1689538563 — DYNASTY 57 BEHAVIORAL HEALTH LLC
Practice Location Address:

2206 W GREENLEAF AVE
CHICAGO, IL
60645-4804

Practice Phone: 773-234-1067
Practice Fax:

1295301315 — MODUPE OJUETIMI OLUKEYE NURSE PRACTITIONER
Practice Location Address:

2206 W GREENLEAF AVE
CHICAGO, IL
60645-4804

Practice Phone: 773-234-1067
Practice Fax:

1962367516 — EMILY TORRE
Practice Location Address:

6840 N SACRAMENTO AVE # 1
CHICAGO, IL
60645-2740

Practice Phone: 877-407-3422
Practice Fax:

Directions to “THRESHOLDS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.