MEDICARE: E.R.I.C. FAMILY SERVICES, 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	251V00000X	Voluntary or Charitable Agency	240509	IL

General Provider Information

NPI Number	:	1841258860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E.R.I.C. FAMILY SERVICES, INC.

Provider Business Mailing Address
First Line	:	6120 W NORTH AVE
Second Line	:	STE 202
City	:	CHICAGO
State	:	IL
Zip	:	60639-3901
Country	:	US
Telephone Number	:	773-745-3742
Fax Number	:	773-745-0655

Provider Business Practice Location Address
First Line	:	6120 W NORTH AVE
Second Line	:	STE 202
City	:	CHICAGO
State	:	IL
Zip	:	60639-3901
Country	:	US
Telephone Number	:	773-745-3742
Fax Number	:	773-745-0655

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. SHEILA C. CURREN
Credential	:	PH.D., LCSW
Telephone Number	:	774-745-3742

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	08/22/2020

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