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Organization
UCAN
Active
Organization
UCAN
Active
Other names
Uhlich Children's Advantage Network
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN STACY (EXECUTIVE ASSISTANT)
(773) 588-0180
Entity
Organization
Contact information
Practice address
10046 S. WESTERN AVE., CHICAGO, IL 60643
(773) 588-0180
Mailing address
3605 W. FILLMORE, CHICAGO, IL 60624-4301
(773) 588-0180
(773) 826-3620
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
—
251K00000X
Public Health or Welfare Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/15/2006
Last updated
12/05/2016
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