1669583001 NPI number — CATHOLIC CHARITIES OF THE ARCHDIOCESE OF CHICAGO

Table of content: (NPI 1669583001)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669583001 NPI number — CATHOLIC CHARITIES OF THE ARCHDIOCESE OF CHICAGO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CATHOLIC CHARITIES OF THE ARCHDIOCESE OF CHICAGO
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:
1669583001
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
05/12/2023
NPI Reactivation Date:
06/02/2023

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
730 N WABASH AVE
Provider Second Line Business Mailing Address:
COURTYARD BUILDING
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60611-2514
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
312-573-8005
Provider Business Mailing Address Fax Number:
312-573-7719

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
730 N WABASH AVE
Provider Second Line Business Practice Location Address:
COURTYARD BUILDING
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60611-2514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-573-8005
Provider Business Practice Location Address Fax Number:
312-573-7719
Provider Enumeration Date:
08/31/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BOLAND
Authorized Official First Name:
MONSIGNOR MICHAEL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
ADMINISTRATOR, PRESIDENT AND CEO
Authorized Official Telephone Number:
312-655-7700

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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