Organization
ASPIRE OF ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEN GAUL (CFO)
(708) 547-3550
Entity
Organization
Contact information
Practice address
1815 S WOLF RD, HILLSIDE, IL 60162-2110
(708) 547-3550
Mailing address
1815 S WOLF RD, HILLSIDE, IL 60162-2110
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178009665
IL
101YP2500X
Professional Counselor
180009732
IL
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/04/2016
Last updated
02/05/2016
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