1871631101 NPI number — JEWISH VOCATIONAL SERVICE AND EMPLOYMENT CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871631101 NPI number — JEWISH VOCATIONAL SERVICE AND EMPLOYMENT CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JEWISH VOCATIONAL SERVICE AND EMPLOYMENT CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871631101
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
216 W JACKSON
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60606
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
312-673-3401
Provider Business Mailing Address Fax Number:
312-553-5544

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2020 W DEVON AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60659-2104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-761-9000
Provider Business Practice Location Address Fax Number:
312-553-5523
Provider Enumeration Date:
02/01/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GOLDSTEIN
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE VICE PRESIDENT
Authorized Official Telephone Number:
312-673-3401

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 04084 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".