NPIMap

Organization Active NPI

Youth Outreach Services

  • Community/Behavioral Health Agency
  • Chicago, IL
National Provider Identifier
1659825560
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
A-0534-0005-A Issued in IL
Legal business name
YOUTH OUTREACH SERVICES
Practice address
6417 W Irving Park Rd
Youth Outreach Services
Chicago, IL 60634-2437
Phone
(773) 777-7112
Fax
(773) 777-7059
NPI assigned
Aug 9, 2016
Last updated
Aug 9, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
YOUTH OUTREACH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Rick Velasquez, MSW
Title
Executive Director
Phone
(773) 777-7112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X A-0534-0005-A IL Primary

Addresses

Primary practice location

6417 W Irving Park Rd
Youth Outreach Services
Chicago, IL 60634-2437

Mailing address

2411 W Congress Pkwy
Youth Outreach Services
Chicago, IL 60612-3534
Phone (773) 777-7112

Other identifiers 1

IdentifierTypeStateIssuer
2B05-IPI-144MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Youth Outreach Services7 organizations share this tax ID, including this one
Part of
Youth Outreach Services

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6417 W Irving Park Rd
Chicago, IL 60634
Phone (773) 706-0428

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1659825560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 W CONGRESS PKWY",
            "address_2": "YOUTH OUTREACH SERVICES",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123534",
            "telephone_number": "773-777-7112",
            "fax_number": "773-777-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6417 W IRVING PARK RD",
            "address_2": "YOUTH OUTREACH SERVICES",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342437",
            "telephone_number": "773-777-7112",
            "fax_number": "773-777-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH OUTREACH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YOUTH OUTREACH SERVICES",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "VELASQUEZ",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "773-777-7112",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "A-0534-0005-A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2B05-IPI-144",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.