Healthcare Provider Details

I. General information

NPI: 1073995841
Provider Name (Legal Business Name): HAND OVER HAND BEHAVIORAL CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2015
Last Update Date: 10/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2248 S MICHIGAN AVE
CHICAGO IL
60616-5258
US

IV. Provider business mailing address

2248 S MICHIGAN AVE
CHICAGO IL
60616-5258
US

V. Phone/Fax

Practice location:
  • Phone: 312-842-5083
  • Fax: 312-842-5086
Mailing address:
  • Phone: 312-842-5083
  • Fax: 312-842-5086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-12-10155
License Number StateIL

VIII. Authorized Official

Name: MS. MEGAN E JAMES
Title or Position: OWNER
Credential: MA BCBA
Phone: 312-842-5083