MEDICARE: KNEW EXPECTATIONS AND ASSOCIATES,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	251S00000X	Community/Behavioral Health Agency	A-4789-0002-A	IL

General Provider Information

NPI Number	:	1972968568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KNEW EXPECTATIONS AND ASSOCIATES,INC.

Provider Business Mailing Address
First Line	:	710 E 47TH ST
Second Line	:	SUITE 203
City	:	CHICAGO
State	:	IL
Zip	:	60653-4202
Country	:	US
Telephone Number	:	773-848-3956
Fax Number	:	312-276-4134

Provider Business Practice Location Address
First Line	:	710 E 47TH ST
Second Line	:	SUITE 203
City	:	CHICAGO
State	:	IL
Zip	:	60653-4202
Country	:	US
Telephone Number	:	773-848-3956
Fax Number	:	312-276-4134

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	MR. PATRICK PRICE
Credential	:	C.A.D.C
Telephone Number	:	773-848-3956

Provider Enumeration Date	:	12/23/2015
Last Update Date	:	12/23/2015

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