Provider Demographics
NPI:1467685669
Name:ASIAN HUMAN SERVICES OF CHICAGO, INC.
Entity Type:Organization
Organization Name:ASIAN HUMAN SERVICES OF CHICAGO, INC.
Other - Org Name:ASIAN HUMAN SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:773-293-8468
Mailing Address - Street 1:4753 N BROADWAY ST STE 700
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-4995
Mailing Address - Country:US
Mailing Address - Phone:773-293-8430
Mailing Address - Fax:773-728-4751
Practice Address - Street 1:1643 W BRYN MAWR AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-4106
Practice Address - Country:US
Practice Address - Phone:773-433-3530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-5003-001-A251S00000X
ILA50030001A261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health