Provider Demographics
NPI:1497178909
Name:JEWISH CHILD & FAMILY SERVICES
Entity Type:Organization
Organization Name:JEWISH CHILD & FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECIEVERABLE
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-673-2703
Mailing Address - Street 1:425 W SURF ST
Mailing Address - Street 2:APT 115
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-6450
Mailing Address - Country:US
Mailing Address - Phone:314-620-8181
Mailing Address - Fax:
Practice Address - Street 1:255 REVERE DR
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1564
Practice Address - Country:US
Practice Address - Phone:847-412-4331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health