- Practice location
- 1029 E 130TH St, Chicago, IL 60628-6908
- Phone
- 773-995-6300
- Fax
- 773-995-6192
- Last updated
- January 13, 2017
7739956300 is a healthcare organization based in Chicago, IL. The NPI number for 7739956300 is 1336685494 and holds license No. 149018713 (IL). The current practice location address is 1029 E 130TH St, Chicago, IL 60628-6908 and the office can be reached by phone at 773-995-6300 and by fax at 773-995-6192. The NPI was assigned on January 13, 2017 and the record was last updated in NPPES on January 13, 2017.
●Provider Profile Details
- NPI Number
- 1336685494
- Provider Name
- 7739956300
- Entity Type
- Organization (Type 2 NPI)
- Primary Taxonomy
- Social Worker, Clinical · 1041C0700X
- Organization Subpart
- No
- Authorized Official
- Ms. Marquetta D Hall, CPCS · Billing Coding Specialist · 773-995-6300
- Enumeration Date
- January 13, 2017
- Last Update Date
- January 13, 2017
- NPI Status
- Active
- Other Names
- Tca Health Care (Former Legal Business Name)
◉Business Practice Location Address
- Address
- 1029 E 130TH St
Chicago, IL 60628-6908 - City
- Chicago
- State
- Illinois
- ZIP
- 60628-6908
- Country
- US
- Phone Number
- 773-995-6300
- Fax Number
- 773-995-6192
✉Business Mailing Address
- Address
- 1029 E.130th Street
Chicago, IL 60628 - City
- Chicago
- State
- IL
- ZIP
- 60628
- Phone Number
- 773-995-6300
- Fax Number
- 773-995-6192
✎Taxonomy & License Information
| Taxonomy | Code | Primary | License | State |
|---|---|---|---|---|
| Social Worker, Clinical 193200000X - Multi-Specialty Group | 1041C0700X | Yes | 149018713 | IL |
#Other Provider Identifiers
No legacy or other identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.
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View all providers in Chicago →?Frequently Asked Questions
What is the NPI number of 7739956300?
The NPI number of 7739956300 is 1336685494. It was assigned on January 13, 2017 and is currently active in the NPPES registry.
What is the specialty of 7739956300?
7739956300 is registered under the primary taxonomy Social Worker, Clinical (code 1041C0700X) and holds license No. 149018713 (IL).
Where does 7739956300 practice?
The practice location is 1029 E 130TH St, Chicago, IL 60628-6908. The office can be reached at 773-995-6300 (phone) or 773-995-6192 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1336685494 directly on the NPPES registry website at npiregistry.cms.hhs.gov.