Provider Demographics
NPI:1699065813
Name:PRIMO CENTER FOR WOMEN AND CHILDREN
Entity type:Organization
Organization Name:PRIMO CENTER FOR WOMEN AND CHILDREN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ACHRE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:773-722-0544
Mailing Address - Street 1:6212 S SANGAMON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60621-2006
Mailing Address - Country:US
Mailing Address - Phone:773-826-7991
Mailing Address - Fax:773-471-6099
Practice Address - Street 1:6212 S SANGAMON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60621-2006
Practice Address - Country:US
Practice Address - Phone:773-826-7991
Practice Address - Fax:773-471-6099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-08
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005578251S00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health