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NPI Code Detail

MEDICARE: GREATER LAWN MENTAL HEALTH CENTER

MEDICARE: GREATER LAWN MENTAL HEALTH CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)IL

General Provider Information

NPI Number : 1760474993
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREATER LAWN MENTAL HEALTH CENTER
Provider Business Mailing Address
First Line : 111 W WASHINGTON ST FL 4
Second Line :
City : CHICAGO
State : IL
Zip : 60602-2703
Country : US
Telephone Number : 312-747-9443
Fax Number : 312-747-9447
Provider Business Practice Location Address
First Line : 4150 W 55TH ST
Second Line : GREATER LAWN MENTAL HEALTH CENTER
City : CHICAGO
State : IL
Zip : 60632-4242
Country : US
Telephone Number : 312-747-1020
Fax Number :
Authorized Official
Title or Position : PROJECT MANAGER
Name : HILLARY WANG
Credential :
Telephone Number : 312-747-8878
Provider Enumeration Date : 08/15/2005
Last Update Date : 04/03/2025

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Directions to “GREATER LAWN MENTAL HEALTH CENTER ” Practice Location

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