MEDICARE: CHICAGO DEPARTMENT OF PUBLIC HEALTH

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)		IL

General Provider Information

NPI Number	:	1932191178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICAGO DEPARTMENT OF PUBLIC HEALTH

Provider Business Mailing Address
First Line	:	CHICAGO DEPARTMENT OF PUBLIC HEALTH
Second Line	:	333 S STATE STREET REVENUE #200
City	:	CHICAGO
State	:	IL
Zip	:	60604
Country	:	US
Telephone Number	:	312-747-9443
Fax Number	:	312-747-9447

Provider Business Practice Location Address
First Line	:	BEVERLY MORGAN PARK MENTAL HEALTH CENTER
Second Line	:	1987 W 111ST STREET
City	:	CHICAGO
State	:	IL
Zip	:	60643
Country	:	US
Telephone Number	:	312-747-1100
Fax Number	:	312-747-2782

Authorized Official
Title or Position	:	DIRECTOR OF REVENUE
Name	:	MRS. SARAI M JACKSON
Credential	:
Telephone Number	:	312-747-9443

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1558765164 — SULAIMON KEHINDE OLADIPO
Practice Location Address:

9415 S WESTERN AVE STE 206
CHICAGO, IL
60643-6700

Practice Phone: 773-301-8464
Practice Fax: 773-530-2643

1861717001 — ADDUS HEALTHCARE INC
Practice Location Address:

2333-2341 W. 95TH ST , , BLDG C, STE 2
CHICAGO, IL
60643-1003

Practice Phone: 312-663-4647
Practice Fax: 312-663-4737

1972501898 — BELHAVEN NURSING AND REHABILITATION CENTER LLC
Practice Location Address:

11401 S OAKLEY AVE
CHICAGO, IL
60643-4196

Practice Phone: 773-233-6311
Practice Fax: 773-233-9304

1346232493 — SOTERIOS G POLYCHRONOPOULOS MD
Practice Location Address:

11638 S WESTERN AVE
CHICAGO, IL
60643

Practice Phone: 773-445-2422
Practice Fax: 773-445-5182

1790777837 — ASKLEPIOS MEDICAL GROUP LTD
Practice Location Address:

11638 S WESTERN AVE
CHICAGO, IL
60643-4730

Practice Phone: 773-445-2422
Practice Fax: 773-445-5182

1790777118 — BEVERLY PODIATRY CENTER, LLC
Practice Location Address:

9933 S WESTERN AVE , SUITE 102
CHICAGO, IL
60643-1810

Practice Phone: 773-445-8700
Practice Fax: 773-445-4646

Directions to “CHICAGO DEPARTMENT OF PUBLIC HEALTH ” 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 © 2007-2026 (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.