Provider Demographics
NPI:1346455151
Name:METROPOLITAN FAMILY SERVICES
Entity Type:Organization
Organization Name:METROPOLITAN FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:C
Authorized Official - Last Name:NIHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-986-4040
Mailing Address - Street 1:101 N WACKER DR STE 1700
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-7384
Mailing Address - Country:US
Mailing Address - Phone:312-986-4000
Mailing Address - Fax:
Practice Address - Street 1:820 DAVIS ST
Practice Address - Street 2:SUITE # 218
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4431
Practice Address - Country:US
Practice Address - Phone:847-328-2404
Practice Address - Fax:847-328-1295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========012Medicaid