# UPTOWN DUI SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124579073
- **Authorized official:** PAUL FITZGERALD JORDAN CADC, MISA I, DUI (DUI / TREATMENT PROVIDER)
- **Authorized official phone:** (312) 451-5184

## Contact information

- **Practice address:** 1525 E 53RD ST STE 411, CHICAGO, IL 60615-4530
- **Practice address phone:** (312) 451-5184
- **Practice address fax:** (708) 896-6580
- **Mailing address:** 1525 E 53RD ST STE 411, CHICAGO, IL 60615-4530
- **Mailing address phone:** (312) 451-5184
- **Mailing address fax:** (708) 896-6580

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | 302F00000X | IL | Yes |

## Other

- **Enumeration date:** 10/16/2016
- **Last updated:** 10/16/2016