Provider Demographics
NPI:1710211917
Name:UHLICH CHILDREN'S ADVANTAGE NETWORK
Entity Type:Organization
Organization Name:UHLICH CHILDREN'S ADVANTAGE NETWORK
Other - Org Name:UCAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, GOVERNMENT & COMMUNITY AFFAIRS
Authorized Official - Prefix:MS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:DOANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-290-5821
Mailing Address - Street 1:3737 N MOZART ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3615
Mailing Address - Country:US
Mailing Address - Phone:773-588-0180
Mailing Address - Fax:773-588-7762
Practice Address - Street 1:1340 S DAMEN AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1169
Practice Address - Country:US
Practice Address - Phone:312-738-5910
Practice Address - Fax:312-666-6978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL121626-10253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency