Organization
SUPPPORTED INDEPENDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA LUCKETT (PRESIDENT)
(630) 667-7370
Entity
Organization
Contact information
Practice address
30 S WACKER DR, SUITE 2200, CHICAGO, IL 60606-7413
(630) 667-7370
(312) 466-5601
Mailing address
30 S WACKER DR, SUITE 2200, CHICAGO, IL 60606-7413
(630) 667-7370
(312) 466-5601
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/11/2011
Last updated
05/11/2011
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