Provider Demographics
NPI:1437280484
Name:TAKE ACTION, INC
Entity Type:Organization
Organization Name:TAKE ACTION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-944-5301
Mailing Address - Street 1:5455 N SHERIDAN RD
Mailing Address - Street 2:1709
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-1958
Mailing Address - Country:US
Mailing Address - Phone:773-944-5301
Mailing Address - Fax:773-944-5302
Practice Address - Street 1:5455 N SHERIDAN RD
Practice Address - Street 2:1709
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-1958
Practice Address - Country:US
Practice Address - Phone:773-944-5301
Practice Address - Fax:773-944-5302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00987103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI15220Medicare ID - Type UnspecifiedMEDICARE PART B