Organization
RINCON FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEDRO PEREZ MBA (CFO)
(773) 564-9070
Entity
Organization
Contact information
Practice address
5457 W DIVERSEY AVE, CHICAGO, IL 60639-1413
(773) 564-9070
Mailing address
3942 W NORTH AVE, CHICAGO, IL 60647-4639
(773) 564-9070
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14003
—
IL
Enumeration date
03/30/2021
Last updated
04/06/2021
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