NPI 1003172404

Psychiatry Specialists

Organisation Community/Behavioral Health Agency Chicago, IL

Practice location

Address: 855 W 103rd St Suite 100, Chicago, IL 60643-2357
Phone: (773) 239-9600
Mailing address: 4535 N Beacon St, Chicago, IL 60640-5518

Authorised official

Name: Angela Ratcliffe
Title: Officer
Phone: (773) 239-9600

Registered specialties (3)

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X Licence 036121844 (IL)

Other Community/Behavioral Health providers in Illinois →

Adult Mental Health Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QM0850X Licence 036121844 (IL)

Other Clinic/Center providers in Illinois →

Adolescent and Children Mental Health Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QM0855X Licence 036121844 (IL)

Registry record

NPI: 1003172404
Entity type: Organization
NPI issued: 10 Apr 2012
Record last updated: 10 Apr 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.