Provider Demographics
NPI:1407212004
Name:ESPERANZA COMMUNITY SERVICES
Entity Type:Organization
Organization Name:ESPERANZA COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:JAYNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DREW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-243-6097
Mailing Address - Street 1:520 N MARSHFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-6731
Mailing Address - Country:US
Mailing Address - Phone:312-243-6097
Mailing Address - Fax:312-243-2076
Practice Address - Street 1:520 N MARSHFIELD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-6731
Practice Address - Country:US
Practice Address - Phone:312-243-6097
Practice Address - Fax:312-243-2076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 106E00000X, 251B00000X, 320900000X
IL11519395251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Multi-Specialty