| Caritas | |
|
140 N Ashland Ave Chicago IL 60607-1802 | |
| (312) 850-9411 | |
| (312) 850-3288 |
| Full Name | Caritas |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 140 N Ashland Ave, Chicago, Illinois |
| Authorized Official Name and Position | Jesseca Watson (CONTRACTS AND CREDENTIALING MANAGER) |
| Authorized Official Contact | 6305728228 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Caritas 1301 W 22nd St Ste 500 Oak Brook IL 60523-2014 Ph: (630) 572-8228 | Caritas 140 N Ashland Ave Chicago IL 60607-1802 Ph: (312) 850-9411 |
| NPI Number | 1235307158 |
|---|---|
| Provider Enumeration Date | 02/13/2008 |
| Last Update Date | 07/21/2020 |
| Certification Date | 07/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235307158 | NPI | - | NPPES |
| 0001 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | C/A-0554-0001-A (Illinois) | Primary |
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