Provider Demographics
NPI:1114801743
Name:CHICAGO CHILDREN'S ADVOCACY CENTER
Entity type:Organization
Organization Name:CHICAGO CHILDREN'S ADVOCACY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-492-3729
Mailing Address - Street 1:1240 S DAMEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-1122
Mailing Address - Country:US
Mailing Address - Phone:312-492-3183
Mailing Address - Fax:
Practice Address - Street 1:1240 S DAMEN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1122
Practice Address - Country:US
Practice Address - Phone:312-492-3183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health