Provider Demographics
NPI:1629025036
Name:JANE ADDAMS HULL HOUSE ASSN
Entity Type:Organization
Organization Name:JANE ADDAMS HULL HOUSE ASSN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-235-5793
Mailing Address - Street 1:1030 W VAN BUREN ST
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2916
Mailing Address - Country:US
Mailing Address - Phone:312-906-8600
Mailing Address - Fax:312-235-5287
Practice Address - Street 1:1030 W VAN BUREN ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2916
Practice Address - Country:US
Practice Address - Phone:312-235-5310
Practice Address - Fax:312-235-5263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========006Medicaid