Provider Demographics
NPI:1144550948
Name:KALEIDOSCOPE INC.
Entity type:Organization
Organization Name:KALEIDOSCOPE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:GRZELAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-292-4076
Mailing Address - Street 1:1901 W CARROLL AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-2401
Mailing Address - Country:US
Mailing Address - Phone:773-278-7200
Mailing Address - Fax:773-278-5663
Practice Address - Street 1:1901 W CARROLL AVE STE 205
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-2401
Practice Address - Country:US
Practice Address - Phone:773-278-7200
Practice Address - Fax:773-278-5663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-30
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL011126-13251B00000X, 253J00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No253J00000XAgenciesFoster Care Agency