Provider Demographics
NPI:1497073241
Name:THE YOUTH CAMPUS
Entity Type:Organization
Organization Name:THE YOUTH CAMPUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUIDI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, CADC
Authorized Official - Phone:847-823-5161
Mailing Address - Street 1:733 N PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-2764
Mailing Address - Country:US
Mailing Address - Phone:847-823-5161
Mailing Address - Fax:847-823-9291
Practice Address - Street 1:901 W JACKSON BLVD
Practice Address - Street 2:5TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3023
Practice Address - Country:US
Practice Address - Phone:312-243-0533
Practice Address - Fax:312-243-7610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL141828253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency