| Youth Outreach Services | |
|
5910 W Division St Youth Outreach Services Chicago IL 60651-1031 | |
| (773) 777-7112 | |
| (773) 887-3300 |
| Full Name | Youth Outreach Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5910 W Division St, Chicago, Illinois |
| Authorized Official Name and Position | Rick Velasquez (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7737777112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Outreach Services 2411 W Congress Pkwy Youth Outreach Services Chicago IL 60612-3534 Ph: (773) 777-7112 | Youth Outreach Services 5910 W Division St Youth Outreach Services Chicago IL 60651-1031 Ph: (773) 777-7112 |
| NPI Number | 1023562303 |
|---|---|
| Provider Enumeration Date | 08/04/2016 |
| Last Update Date | 08/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023562303 | NPI | - | NPPES |
| 2B05-IPI-144 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | A-0534-0007-A (Illinois) | Primary |
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