Provider Demographics
NPI:1215372123
Name:YMCA OF METROPOLITAN CHICAGO
Entity Type:Organization
Organization Name:YMCA OF METROPOLITAN CHICAGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-932-1200
Mailing Address - Street 1:801 N DEARBORN ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-3316
Mailing Address - Country:US
Mailing Address - Phone:312-932-1200
Mailing Address - Fax:312-932-1318
Practice Address - Street 1:801 N DEARBORN ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-3316
Practice Address - Country:US
Practice Address - Phone:312-932-1200
Practice Address - Fax:312-932-1318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care