Organization
IBUKUN COMPREHENSIVE COMMUNITY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTIAN AKIWOWO PH.D. (EXECUTIVE DIRECTOR)
(773) 994-6125
Entity
Organization
Contact information
Practice address
6752 S PERRY AVE, CHICAGO, IL 60621-3714
(773) 994-6125
(773) 994-6135
Mailing address
6752 S PERRY AVE, CHICAGO, IL 60621-3714
(773) 994-6125
(773) 994-6135
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
180004168
IL
Other
Enumeration date
10/24/2011
Last updated
10/24/2011
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