Provider Demographics
NPI:1871771535
Name:CHICAGO DEPARTMENT OF SENIOR SERVICES
Entity type:Organization
Organization Name:CHICAGO DEPARTMENT OF SENIOR SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COMMISSIONER
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-744-5770
Mailing Address - Street 1:30 N LASALLE ST
Mailing Address - Street 2:SUITE 2320
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-2590
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 N LASALLE ST
Practice Address - Street 2:SUITE 2320
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-2590
Practice Address - Country:US
Practice Address - Phone:312-744-0890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF CHICAGO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center