Provider Demographics
NPI:1528390929
Name:MAKING THE DIFFERENCE INTERNATIONAL, INC
Entity Type:Organization
Organization Name:MAKING THE DIFFERENCE INTERNATIONAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GRABCZYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:312-607-1385
Mailing Address - Street 1:27 N WACKER DR
Mailing Address - Street 2:SUITE 166
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-2800
Mailing Address - Country:US
Mailing Address - Phone:312-607-1385
Mailing Address - Fax:773-548-6400
Practice Address - Street 1:1325 S WABASH AVE STE 302
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2536
Practice Address - Country:US
Practice Address - Phone:312-607-1385
Practice Address - Fax:312-277-6113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0084221041C0700X
1041C0700X, 251S00000X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001528390929Medicaid
IL2784763OtherCIGNA BEHAVIORAL HEALTH