Provider Demographics
NPI:1902084247
Name:HUMAN RESOURCES DEVELOPMENT INSTITUTE- CHICAGO TEENS
Entity Type:Organization
Organization Name:HUMAN RESOURCES DEVELOPMENT INSTITUTE- CHICAGO TEENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:EFFIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:BARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-441-9009
Mailing Address - Street 1:222 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-5603
Mailing Address - Country:US
Mailing Address - Phone:312-441-9009
Mailing Address - Fax:312-441-9019
Practice Address - Street 1:2311 E 98TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-4842
Practice Address - Country:US
Practice Address - Phone:773-933-5570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUMAN RESOURCES DEVELOPMENT INSTITUTE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health