Nine Forty Cullom Corporation
Nine Forty Cullom Corporation is a Mental Illness Intermediate Care Facility in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2005.
- Licensed in
- IL
- In the registry since
- 2005
Practice location Address checks out
940 W Cullom AveChicago, IL 60613
Phone: (773) 525-9000
Fax: (773) 525-8016
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Specialties & licences
| Mental Illness Intermediate Care Facility (primary) | Taxonomy 310500000X · Licence 0017178 (IL) |
|---|
Record details
| NPI number | 1912998188 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Peter Obrien — President · (312) 787-9400 |
| Other names | Mado Healthcare - Buena Park |
| NPI enumerated | November 4, 2005 |
| Last updated in NPPES | April 15, 2019 |
| Mailing address | 405 N Wabash Ave Ste P2w, Chicago, IL 60611-3541 |
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