Organization
ENVISION UNLIMITED
Active
Other names
CARC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRISTIN V MACRAE (PRESIDENT CHIEF EXECUTIVE OFFICER)
(312) 346-6230
Entity
Organization
Contact information
Practice address
8 SOUTH MICHIGAN AVENUE, SUITE 1700, CHICAGO, IL 60603-3353
(312) 346-6230
(312) 346-2218
Mailing address
8 SOUTH MICHIGAN AVENUE, SUITE 1700, CHICAGO, IL 60603-3353
(312) 346-6230
(312) 346-2218
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01630144
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/07/2007
Last updated
11/03/2010
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