Organization
MIDWEST BRAIN INJURY CLUBHOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMIKO BESS (EXECUTIVE DIRECTOR)
(312) 226-8714
Entity
Organization
Contact information
Practice address
1021 W ADAMS ST., SUITE 200, CHICAGO, IL 60607-2936
(312) 226-8720
(312) 226-8722
Mailing address
1021 W ADAMS ST STE 200, CHICAGO, IL 60607-2936
(312) 226-8720
(312) 226-8722
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
10/14/2014
Last updated
12/20/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up