1194105882 NPI number — ASIAN HUMAN SERVICES OF CHICAGO INC.

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 1194105882 NPI number — ASIAN HUMAN SERVICES OF CHICAGO INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASIAN HUMAN SERVICES OF CHICAGO INC.
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:
ASIAN HUMAN SERVICES INC.
Provider Other Organization Name Type Code:
3
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:
1194105882
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4753 N BROADWAY ST STE 700
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:
60640-4995
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-293-8430
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8800 LOCKWOOD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SKOKIE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60077-1500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-983-1400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/08/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MAKI
Authorized Official First Name:
CRAIG
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
773-293-8448

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  A-5003-0001-A , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X , with the licence number: A-5003-0001-A , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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