Provider Demographics
NPI:1669642815
Name:COOK COUNTY ADULT PROBATION
Entity Type:Organization
Organization Name:COOK COUNTY ADULT PROBATION
Other - Org Name:MENTAL HEALTH UNIT
Other - Org Type:Other Name
Authorized Official - Title/Position:DEPUTY CHIEF
Authorized Official - Prefix:MS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:NERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-869-3333
Mailing Address - Street 1:69 W WASHINGTON ST STE 1940
Mailing Address - Street 2:COOK COUNTY ADMINISTRATION BUILDING
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3035
Mailing Address - Country:US
Mailing Address - Phone:312-603-0258
Mailing Address - Fax:312-603-9992
Practice Address - Street 1:2650 S CALIFORNIA AVE LOWR LEVEL
Practice Address - Street 2:MENTAL HEALTH UNIT
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-5146
Practice Address - Country:US
Practice Address - Phone:773-869-3333
Practice Address - Fax:773-869-4380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04038Medicaid