Provider Demographics
NPI:1649413659
Name:JEWISH VOCATIONAL SERVICE
Entity Type:Organization
Organization Name:JEWISH VOCATIONAL SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:312-673-3405
Mailing Address - Street 1:216 W JACKSON BLVD
Mailing Address - Street 2:700
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-6909
Mailing Address - Country:US
Mailing Address - Phone:312-673-3405
Mailing Address - Fax:312-553-5544
Practice Address - Street 1:950 E 61ST ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-2623
Practice Address - Country:US
Practice Address - Phone:773-493-3400
Practice Address - Fax:312-553-5521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL002251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========002Medicaid