Chicago Pride Center | |
4809 N Ravenswood Ave Unit 210 Chicago IL 60640-4417 | |
(773) 334-3533 | |
Not Available |
Full Name | Chicago Pride Center |
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Speciality | Social Worker |
Location | 4809 N Ravenswood Ave Unit 210, Chicago, Illinois |
Authorized Official Name and Position | Hugh Cole (CFO) |
Authorized Official Contact | 7733343533 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Chicago Pride Center 25 E Washington St Ste 1811 Chicago IL 60602-1830 Ph: (773) 319-4325 | Chicago Pride Center 4809 N Ravenswood Ave Unit 210 Chicago IL 60640-4417 Ph: (773) 334-3533 |
NPI Number | 1114406873 |
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Provider Enumeration Date | 08/13/2018 |
Last Update Date | 07/11/2023 |
Certification Date | 07/11/2023 |
Medicare PECOS PAC ID | 1456687193 |
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Medicare Enrollment ID | O20190801002430 |
Identifier | Type | State | Issuer |
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1114406873 | NPI | - | NPPES |
Provider Name | Hugh L Cole |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1346681350 PECOS PAC ID: 8426356122 Enrollment ID: I20160413001493 |
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