Organization
THRESHOLDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY ZIPPLE (CEO)
(773) 572-5500
Entity
Organization
Contact information
Practice address
6710 N SHERIDAN RD, CHICAGO, IL 60626-4505
(773) 572-5500
Mailing address
4101 N RAVENSWOOD AVE, CHICAGO, IL 60613-2193
(773) 572-5500
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
04133
IL
Other
Enumeration date
02/17/2011
Last updated
02/17/2011
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