Healthcare Provider Details

I. General information

NPI: 1699190082
Provider Name (Legal Business Name): ASSOCIATION FOR MULTICULTURAL BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2014
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6650 N NORTHWEST HWY
CHICAGO IL
60631-1307
US

IV. Provider business mailing address

326 ELK BLVD
DES PLAINES IL
60016-3506
US

V. Phone/Fax

Practice location:
  • Phone: 773-392-9103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number22119
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149014886
License Number StateIL

VIII. Authorized Official

Name: ANGELIKA DANEK
Title or Position: FOUNDER/PRINCIPAL
Credential:
Phone: 773-392-9103