Provider Demographics
NPI:1245530351
Name:EPILEPSY FOUNDATION OF GREATER CHICAGO
Entity type:Organization
Organization Name:EPILEPSY FOUNDATION OF GREATER CHICAGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:M
Authorized Official - Last Name:GATTONE
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:312-939-8622
Mailing Address - Street 1:17 N. STATE ST.
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3297
Mailing Address - Country:US
Mailing Address - Phone:312-939-8622
Mailing Address - Fax:312-939-0391
Practice Address - Street 1:17 N STATE ST
Practice Address - Street 2:SUITE 1300
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3315
Practice Address - Country:US
Practice Address - Phone:312-939-8622
Practice Address - Fax:312-939-0391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251V00000X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or Charitable