Organization
MARYVILLE ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK SMITH (ADMINISTRATOR OF COMMUNITY SERVICES)
(847) 390-3004
Entity
Organization
Contact information
Practice address
4909 W DIVISION ST STE 407, CHICAGO, IL 60651-3161
(847) 390-3004
Mailing address
4909 W DIVISION ST STE 407, CHICAGO, IL 60651-3161
(847) 390-3004
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/17/2026
Last updated
04/17/2026
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