Provider Demographics
NPI:1790834448
Name:CORNERSTONE COUNSELING CENTER OF CHICAGO
Entity Type:Organization
Organization Name:CORNERSTONE COUNSELING CENTER OF CHICAGO
Other - Org Name:CENTER FOR LIFE SKILLS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:E.
Authorized Official - Middle Name:SUSANNE
Authorized Official - Last Name:FRANCIS-THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:312-573-8860
Mailing Address - Street 1:1111 N WELLS ST STE 400
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-7632
Mailing Address - Country:US
Mailing Address - Phone:312-573-8860
Mailing Address - Fax:312-255-0362
Practice Address - Street 1:1111 N WELLS ST STE 400
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-7632
Practice Address - Country:US
Practice Address - Phone:312-573-8860
Practice Address - Fax:312-255-0362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X, 103TC0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty