Provider Demographics
NPI:1861724544
Name:CHICAGO DEPT. OF PUBLIC HEALTH
Entity type:Organization
Organization Name:CHICAGO DEPT. OF PUBLIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY COMMISSIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIPPERTON-LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-747-9891
Mailing Address - Street 1:333 SOUTH STATE STREET
Mailing Address - Street 2:DEPAUL CENTER, SUITE 200
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604
Mailing Address - Country:US
Mailing Address - Phone:312-747-9891
Mailing Address - Fax:
Practice Address - Street 1:200 E 115TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-5015
Practice Address - Country:US
Practice Address - Phone:312-747-7320
Practice Address - Fax:312-747-6252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.012350251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health