| The Humble Haven Chicago | |
|
4949 Forest Ave Ste 2 Downers Grove IL 60515-3580 | |
| (312) 927-1830 | |
| Not Available |
| Full Name | The Humble Haven Chicago |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4949 Forest Ave Ste 2, Downers Grove, Illinois |
| Authorized Official Name and Position | Sara Rose Shotsberger (CEO/ CFO) |
| Authorized Official Contact | 3128347440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Humble Haven Chicago 3707 W Cullom Ave Unit 1 Chicago IL 60618-2004 Ph: (312) 927-1830 | The Humble Haven Chicago 4949 Forest Ave Ste 2 Downers Grove IL 60515-3580 Ph: (312) 927-1830 |
| NPI Number | 1912599242 |
|---|---|
| Provider Enumeration Date | 02/08/2021 |
| Last Update Date | 02/08/2021 |
| Certification Date | 02/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912599242 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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