Organization
COMMUNITY COUNSELING CENTERS OF CHICAGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY DAVIS (REVENUE CYCLE MANAGER)
(872) 235-0258
Entity
Organization
Contact information
Practice address
2542 W NORTH AVE, CHICAGO, IL 60647-5216
(773) 365-7277
Mailing address
2014 W BELLE PLAINE AVE, CHICAGO, IL 60618-3002
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
02/03/2023
Last updated
02/03/2023
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