| Juvenile Protective Association | |
|
1707 N Halsted St Chicago IL 60614-5501 | |
| (312) 440-9034 | |
| Not Available |
| Full Name | Juvenile Protective Association |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1707 N Halsted St, Chicago, Illinois |
| Authorized Official Name and Position | Tracy Gilmore (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7733323058 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Juvenile Protective Association 1707 N Halsted St Chicago IL 60614-5501 Ph: (312) 440-9034 | Juvenile Protective Association 1707 N Halsted St Chicago IL 60614-5501 Ph: (312) 440-9034 |
| NPI Number | 1023559705 |
|---|---|
| Provider Enumeration Date | 03/15/2017 |
| Last Update Date | 03/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023559705 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 149018731 (Illinois) | Primary |
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