Organization
CHICAGO DEPARTMENT OF PUBLIC HEALTH
Active
Other names
CDPH
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARAI M JACKSON (DIRECTOR OF REVENUE)
(312) 747-9443
Entity
Organization
Contact information
Practice address
1140 W 79TH ST, CHICAGO, IL 60620-3029
(312) 747-0881
(312) 747-7796
Mailing address
333 S STATE ST, REVENUE #200, CHICAGO, IL 60604-3900
(312) 747-9443
(312) 747-9447
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
IL
Other
Enumeration date
08/15/2005
Last updated
08/22/2020
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