Provider Demographics
NPI:1316790694
Name:NORTHWESTERN UNIVERSITY SETTLEMENT ASSOCIATION
Entity type:Organization
Organization Name:NORTHWESTERN UNIVERSITY SETTLEMENT ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FAMILY CARES
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIDEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:773-569-9553
Mailing Address - Street 1:1012 N NOBLE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-4011
Mailing Address - Country:US
Mailing Address - Phone:773-278-7471
Mailing Address - Fax:855-273-4414
Practice Address - Street 1:1420 W AUGUSTA BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-3939
Practice Address - Country:US
Practice Address - Phone:773-278-7471
Practice Address - Fax:855-273-4414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty