Organization
UCAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZACK SCHRANTZ (PRESIDENT/CEO)
(773) 588-0180
Entity
Organization
Contact information
Practice address
212 S FRANCISCO AVE, CHICAGO, IL 60612-3618
(773) 696-3210
(773) 217-9364
Mailing address
3605 W FILLMORE ST, CHICAGO, IL 60624-4310
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
—
2B05-CHR-011
—
IL
Enumeration date
04/17/2019
Last updated
04/17/2019
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