Provider Demographics
NPI:1396303699
Name:ASSYRIAN AMERICAN ASSOCIATION OF CHICAGO, INC.,
Entity type:Organization
Organization Name:ASSYRIAN AMERICAN ASSOCIATION OF CHICAGO, INC.,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ISHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-802-2208
Mailing Address - Street 1:1618 W DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-1214
Mailing Address - Country:US
Mailing Address - Phone:773-338-3922
Mailing Address - Fax:
Practice Address - Street 1:1618 W DEVON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-1214
Practice Address - Country:US
Practice Address - Phone:773-338-3922
Practice Address - Fax:773-973-6005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-31
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No251S00000XAgenciesCommunity/Behavioral Health