Provider Demographics
NPI:1144803438
Name:4D CARE ASSIST FOUNDATION
Entity Type:Organization
Organization Name:4D CARE ASSIST FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-309-4874
Mailing Address - Street 1:401 N MICHIGAN AVE, SUITE 1740
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:224-633-9472
Mailing Address - Fax:630-857-9069
Practice Address - Street 1:401 N MICHIGAN AVE, SUITE 1740
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:224-633-9472
Practice Address - Fax:630-857-9069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty