Provider Demographics
NPI:1093921603
Name:THE CHICAGO LIGHTHOUSE FOR PEOPLE WHO ARE BLIND OR VISUALLY IMPAIRED
Entity Type:Organization
Organization Name:THE CHICAGO LIGHTHOUSE FOR PEOPLE WHO ARE BLIND OR VISUALLY IMPAIRED
Other - Org Name:BIRTH-TO-THREE PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARSTKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-510-2053
Mailing Address - Street 1:1850 W ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-1228
Mailing Address - Country:US
Mailing Address - Phone:312-666-1331
Mailing Address - Fax:312-506-0103
Practice Address - Street 1:1850 W ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1200
Practice Address - Country:US
Practice Address - Phone:847-510-2053
Practice Address - Fax:312-506-0103
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CHICAGO LIGHTHOUSE FOR PEOPLE WHO ARE BLIND OR VISUALLY IMPAIRED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-14
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty