| Children's Home & Aid Society Of Illinois | |
|
1501 Interstate Dr Suite B Champaign IL 61822-1006 | |
| (217) 530-4029 | |
| Not Available |
| Full Name | Children's Home & Aid Society Of Illinois |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1501 Interstate Dr, Champaign, Illinois |
| Authorized Official Name and Position | Mike Shaver (PRESIDENT/CEO) |
| Authorized Official Contact | 3124246801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Home & Aid Society Of Illinois 200 W Monroe St Ste 2100 Chicago IL 60606-5071 Ph: (312) 424-0200 | Children's Home & Aid Society Of Illinois 1501 Interstate Dr Suite B Champaign IL 61822-1006 Ph: (217) 530-4029 |
| NPI Number | 1467818138 |
|---|---|
| Provider Enumeration Date | 01/11/2016 |
| Last Update Date | 07/01/2022 |
| Certification Date | 06/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467818138 | NPI | - | NPPES |
| 2B05IPI129 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2B05IPI129 (Illinois) | Primary |
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