Provider Demographics
NPI:1407244874
Name:COMMUNITY LINKS OF CHICAGO INC
Entity Type:Organization
Organization Name:COMMUNITY LINKS OF CHICAGO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:773-425-1760
Mailing Address - Street 1:4037 W GLADYS AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60624-2708
Mailing Address - Country:US
Mailing Address - Phone:773-425-1760
Mailing Address - Fax:
Practice Address - Street 1:4037 W GLADYS AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-2708
Practice Address - Country:US
Practice Address - Phone:773-425-1760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.014137251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health