| Ican Dream Center Nfp | |
|
17512 E Carriageway Dr Hazel Crest IL 60429-2091 | |
| (708) 798-4200 | |
| Not Available |
| Full Name | Ican Dream Center Nfp |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 17512 E Carriageway Dr, Hazel Crest, Illinois |
| Authorized Official Name and Position | Evisha Ford (DIRECTOR) |
| Authorized Official Contact | 7083070440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ican Dream Center Nfp 17512 E Carriageway Dr Hazel Crest IL 60429-2091 Ph: (708) 798-4200 | Ican Dream Center Nfp 17512 E Carriageway Dr Hazel Crest IL 60429-2091 Ph: (708) 798-4200 |
| NPI Number | 1114415080 |
|---|---|
| Provider Enumeration Date | 04/26/2018 |
| Last Update Date | 04/26/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114415080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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