Healthcare Provider Details
I. General information
NPI: 1003745217
Provider Name (Legal Business Name): CLINICAL HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
211 N HARBOR DR APT 1007
CHICAGO IL
60601-7583
US
IV. Provider business mailing address
211 N HARBOR DR APT 1007
CHICAGO IL
60601-7583
US
V. Phone/Fax
- Phone: 312-292-7365
- Fax:
- Phone: 312-292-7365
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 102L00000X |
| Taxonomy | Psychoanalyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083C0008X |
| Taxonomy | Clinical Informatics Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 405300000X |
| Taxonomy | Prevention Professional |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MONICA
YORK
Title or Position: OWNER
Credential:
Phone: 312-292-7365