1619921566 NPI number — COUNCIL FOR JEWISH ELDERLY

Table of content: (NPI 1619921566)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619921566 NPI number — COUNCIL FOR JEWISH ELDERLY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNCIL FOR JEWISH ELDERLY
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:
CJE SENIORLIFE
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:
1619921566
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3003 W TOUHY AVE
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:
60645-2833
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-508-1000
Provider Business Mailing Address Fax Number:
773-508-1028

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1015 HOWARD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EVANSTON
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60202-3823
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-508-1000
Provider Business Practice Location Address Fax Number:
773-508-1028
Provider Enumeration Date:
05/22/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TURNER
Authorized Official First Name:
STACEY
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
773-508-1075

Provider Taxonomy Codes

  • Taxonomy code: 261QA0600X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332U00000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 343800000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 343900000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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