Provider Demographics
NPI:1568743482
Name:HAVE DREAMS
Entity Type:Organization
Organization Name:HAVE DREAMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:847-685-0250
Mailing Address - Street 1:515 BUSSE HWY
Mailing Address - Street 2:150
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-3154
Mailing Address - Country:US
Mailing Address - Phone:847-685-0250
Mailing Address - Fax:847-685-0257
Practice Address - Street 1:515 BUSSE HWY
Practice Address - Street 2:150
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-3154
Practice Address - Country:US
Practice Address - Phone:847-685-0250
Practice Address - Fax:847-685-0257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health