| Children's Home And Aid | |
|
1501 Interstate Dr Ste B Champaign IL 61822-1007 | |
| (217) 530-4040 | |
| Not Available |
| Full Name | Children's Home And Aid |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1501 Interstate Dr Ste B, Champaign, Illinois |
| Authorized Official Name and Position | Mike Shaver (PRESIDENT/CEO) |
| Authorized Official Contact | 1242468013 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Home And Aid 200 W Monroe St Ste 2100 Chicago IL 60606-5071 Ph: (312) 424-0200 | Children's Home And Aid 1501 Interstate Dr Ste B Champaign IL 61822-1007 Ph: (217) 530-4040 |
| NPI Number | 1164957924 |
|---|---|
| Provider Enumeration Date | 04/28/2017 |
| Last Update Date | 07/01/2022 |
| Certification Date | 06/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164957924 | NPI | - | NPPES |
| 2B05-IPI-129 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2B05-IPI-129 (Illinois) | Primary |
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