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Organization

JUVENILE PROTECTIVE ASSOCIATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TRACY GILMORE LCSW (CLINICAL DIRECTOR)
(773) 332-3058
Entity
Organization

Contact information

Practice address
1707 N HALSTED ST, CHICAGO, IL 60614-5501
(312) 440-9034
Mailing address
1707 N HALSTED ST, CHICAGO, IL 60614-5501
(312) 440-9034

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
149018731
IL

Other

Enumeration date
03/15/2017
Last updated
03/15/2017
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