Provider Demographics
NPI:1700894979
Name:I AM ABLE CENTER FOR FAMILY DEVELOPMENT, INC.
Entity Type:Organization
Organization Name:I AM ABLE CENTER FOR FAMILY DEVELOPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:VESSEL
Authorized Official - Suffix:
Authorized Official - Credentials:BA, MSHSA, M-DIV,DD
Authorized Official - Phone:773-840-8061
Mailing Address - Street 1:3410 WEST ROOSEVELT ROAD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60624-4343
Mailing Address - Country:US
Mailing Address - Phone:773-826-2929
Mailing Address - Fax:773-826-2964
Practice Address - Street 1:3410 W ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-4343
Practice Address - Country:US
Practice Address - Phone:773-826-2929
Practice Address - Fax:773-826-2964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)