MEDICARE: L ARCHE CHICAGO

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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1972971778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L ARCHE CHICAGO

Provider Business Mailing Address
First Line	:	7313 MADISON ST
Second Line	:
City	:	FOREST PARK
State	:	IL
Zip	:	60130-1727
Country	:	US
Telephone Number	:	708-660-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	7313 MADISON ST
Second Line	:
City	:	FOREST PARK
State	:	IL
Zip	:	60130-1727
Country	:	US
Telephone Number	:	708-660-1600
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MICHAEL ALTENA
Credential	:
Telephone Number	:	708-660-1600

Provider Enumeration Date	:	09/10/2015
Last Update Date	:	09/19/2025

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Directions to “L ARCHE CHICAGO ” Practice Location

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