Organization
KIDS ABOVE ALL ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JERI L LAUREANO LCSW (CHIEF OPERATING OFFICER)
(773) 239-8940
Entity
Organization
Contact information
Practice address
8765 W. HIGGINS, SUITE 450, CHICAGO, IL 60631
(773) 693-0300
(773) 693-0322
Mailing address
8765 W. HIGGINS ROAD, SUITE 450, CHICAGO, IL 60631
(773) 693-0300
(773) 693-0322
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
012033-10
IL
320800000X
Mental Illness Community Based Residential Treatment Facility
012033-10
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2B05CHR013
—
IL
Enumeration date
08/30/2006
Last updated
04/19/2021
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