Childhood Trauma Treatment Program of Advocate Health & Hospitals Corp
Organization Active NPI Adolescent and Children Mental Health Clinic/Center · Oak Lawn, IL
NPI 1881919488 · NPPES record last updated Apr 7, 2010
Key facts
- NPI
- 1881919488
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adolescent and Children Mental Health Clinic/Center 261QM0855X
- Legal business name
- CHILDHOOD TRAUMA TREATMENT PROGRAM OF ADVOCATE HEALTH & HOSPITALS CORP
- Practice address
- 4700 W 95TH St
LL5
Oak Lawn, IL 60453-2533 - Phone
- (800) 216-1110
- Fax
- (708) 346-4868
- NPI assigned
- Apr 7, 2010
- Organization subpart
- Yes
- Parent organization (as reported)
- FAMILY CARE NETWORK OF ADVOCATE HEALTH & HOSPITALS CORP.
Authorized official
- Name
- Dr. Gene S. Carroccia, PSY.D.
- Title
- Clinical Director
- Phone
- (800) 216-1110
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Adovate Health Hosp Corp
- Part of
- Adovate Health Hosp Corp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Adult Mental Health Clinic/Center | 261QM0850X | |||
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | Yes |
Addresses
Primary practice location
4700 W 95TH St
LL5
Oak Lawn, IL 60453-2533
Mailing address
PO Box 776
Childhood Trauma Treatment Program
Oak Lawn, IL 60454-0776
Phone (800) 216-1110
Other names
- Childhood Trauma Treatment Program
Other providers in Oak Lawn, IL
- Chicago South Orthopedics, Inc
- Chicagoland Pediatric Partners PC
- Krystina Chickerillo
- Aida Altagracia Chicon
- Childhood Trauma Treatment Program of Advocate Health & Hospitals Corp
- Victoria Lashay Sierra Childs
- Chiro One Wellness Center of Oak Lawn LLC
- Ashley Choi
- Eunice Ye Eun Choi
- Michelle Chong
All providers in Oak Lawn, IL · Adolescent and Children Mental Health Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.