Provider Demographics
NPI:1538550538
Name:MIDWEST CENTER FOR HOPE & HEALING
Entity type:Organization
Organization Name:MIDWEST CENTER FOR HOPE & HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:NATALIE
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:630-560-1100
Mailing Address - Street 1:1000 JORIE BLVD STE 36
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-4501
Mailing Address - Country:US
Mailing Address - Phone:630-560-1100
Mailing Address - Fax:630-487-5626
Practice Address - Street 1:1000 JORIE BLVD STE 36
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4501
Practice Address - Country:US
Practice Address - Phone:630-560-1100
Practice Address - Fax:630-487-5626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2020-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007407101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty