Organization
CARITAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSECA WATSON (CONTRACTS AND CREDENTIALING MANAGER)
(630) 572-8228
Entity
Organization
Contact information
Practice address
140 N ASHLAND AVE, CHICAGO, IL 60607-1802
(312) 850-9411
(312) 850-3288
Mailing address
1301 W 22ND ST STE 500, OAK BROOK, IL 60523-2014
(630) 572-8228
(630) 572-0566
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C/A-0554-0001-A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001
—
IL
Enumeration date
02/13/2008
Last updated
07/21/2020
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