AMERICAN INDIAN HEALTH SERVICE OF CHICAGO INC NPI 1396194692

NPI Information

AMERICAN INDIAN HEALTH SERVICE OF CHICAGO INC is a mental health (including community mental health center) clinic center in Chicago, IL. AMERICAN INDIAN HEALTH SERVICE OF CHICAGO INC NPI is 1396194692. The provider is registered as an organization entity type.

The provider's business location address is:

4326 W MONTROSE AVE
CHICAGO, IL
ZIP 60641-016
Phone: (773) 883-9100
Fax: (773) 883-0005

The provider's authorized official is Roxanne M Lavallie-unabia .
The authorized official title is Executive Director and has the following contact phone number (773) 883-9100.

The CLIA number assigned to this NPI record is 14D1002440 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/7/2016 and was last updated on 12/31/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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