Provider Demographics
NPI:1881766731
Name:UNITED STATES CONFERENCE OF CATHOLIC BISHOPS - CLARET CENTER INC.
Entity type:Organization
Organization Name:UNITED STATES CONFERENCE OF CATHOLIC BISHOPS - CLARET CENTER INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CABELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-643-6259
Mailing Address - Street 1:PO BOX 15219
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-5140
Mailing Address - Country:US
Mailing Address - Phone:773-643-6259
Mailing Address - Fax:773-643-6929
Practice Address - Street 1:5536 S EVERETT AVENUE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637
Practice Address - Country:US
Practice Address - Phone:773-643-6259
Practice Address - Fax:773-643-6929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1616560OtherBCBS
IL583160Medicare ID - Type Unspecified