Organization
KC CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH G WILSON LCSW (DIRECTOR)
(312) 801-6219
Entity
Organization
Contact information
Practice address
1525 E 53RD ST STE 428, CHICAGO, IL 60615-4575
(312) 801-6219
(773) 326-0871
Mailing address
1525 E 53RD ST STE 428, CHICAGO, IL 60615-4575
(312) 801-6219
(773) 326-0871
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
361562877001
—
IL
Enumeration date
06/13/2019
Last updated
06/13/2019
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