Provider Demographics
NPI:1922570902
Name:CAPER CHILDREN'S SERVICES LLC
Entity Type:Organization
Organization Name:CAPER CHILDREN'S SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GHEZALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-731-3051
Mailing Address - Street 1:4045 N LAPORTE AVE APT G2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-1759
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4045 N LAPORTE AVE APT G2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-1759
Practice Address - Country:US
Practice Address - Phone:312-731-3051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-01
Last Update Date:2019-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health