Provider Demographics
NPI:1447584990
Name:UCAN
Entity Type:Organization
Organization Name:UCAN
Other - Org Name:UCAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZACK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-588-0180
Mailing Address - Street 1:3605 W. FILLMORE ST.
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60624
Mailing Address - Country:US
Mailing Address - Phone:773-588-0180
Mailing Address - Fax:773-588-7762
Practice Address - Street 1:3605 W. FILLMORE ST.
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-4309
Practice Address - Country:US
Practice Address - Phone:773-588-0180
Practice Address - Fax:773-588-7762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 261QM0801X
IL12162610253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No253J00000XAgenciesFoster Care Agency