Provider Demographics
NPI:1952680712
Name:CHILDREN'S HOME AND AID
Entity Type:Organization
Organization Name:CHILDREN'S HOME AND AID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-424-6801
Mailing Address - Street 1:125 S WACKER DR
Mailing Address - Street 2:14TH FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-4424
Mailing Address - Country:US
Mailing Address - Phone:312-424-6823
Mailing Address - Fax:312-424-6800
Practice Address - Street 1:1115 EAST TAYLOR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701
Practice Address - Country:US
Practice Address - Phone:309-827-0374
Practice Address - Fax:309-828-0745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-11
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health