Provider Demographics
NPI:1104462464
Name:ASIAN HUMAN SERVICES, PALATINE
Entity type:Organization
Organization Name:ASIAN HUMAN SERVICES, PALATINE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-924-4768
Mailing Address - Street 1:4753 N BROADWAY ST STE 700
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-4995
Mailing Address - Country:US
Mailing Address - Phone:773-293-8400
Mailing Address - Fax:
Practice Address - Street 1:1585 N RAND RD STE 530
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-2919
Practice Address - Country:US
Practice Address - Phone:773-293-8194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASIAN HUMAN SERVICES OF CHICAGO, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-21
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health