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Agencies Community/Behavioral Health

Provider NPI: 1265907539

Organization Information:
Organization is not Subpart
Authorized Official:  MEGAN  MILLS  OWNER/CLINICAL PSYCHOLOGIST  773-331-7690

Practice Location:
2800 N SHERIDAN RD STE 108  CHICAGO, IL 60657-6183 US
Tel: 773-331-7690  Fax: --

Business Mailing Address:
3200 N LAKE SHORE DR APT 2505  CHICAGO, IL 60657-3929 US
Tel: 773-331-7690  Fax: --

NPI Information:
NPI: 1265907539
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Community/Behavioral Health
N103TA0700XBehavioral Health & Social Service Providers
N103TC0700XBehavioral Health & Social Service Providers
Y103TH0004XBehavioral Health & Social Service Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 103TH0004X





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