Provider Demographics
NPI:1497006563
Name:ASI
Entity type:Organization
Organization Name:ASI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:773-278-5130
Mailing Address - Street 1:2619 W. ARMITAGE AVE.
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-4208
Mailing Address - Country:US
Mailing Address - Phone:773-278-5130
Mailing Address - Fax:773-278-1380
Practice Address - Street 1:2619 W. ARMITAGE AVE.
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-4208
Practice Address - Country:US
Practice Address - Phone:773-278-5130
Practice Address - Fax:773-278-1380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-28
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty