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Organization
CARITAS
Active
Organization
CARITAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSECA WATSON (CREDENTIALING MANAGER)
(630) 572-8228
Entity
Organization
Contact information
Practice address
140 N ASHLAND AVE, CHICAGO, IL 60607-1802
(312) 850-0050
(312) 850-9095
Mailing address
1301 W 22ND ST, SUITE 800, OAK BROOK, IL 60523-2006
(630) 572-8228
(630) 572-0566
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
07008
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006
—
IL
05
—
07008
—
IL
Enumeration date
08/28/2009
Last updated
10/22/2020
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