Healthcare Provider Details

I. General information

NPI: 1033569470
Provider Name (Legal Business Name): SITHUB DBA CHICAGO THERAPY COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2016
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1757 N KIMBALL AVE STE 202
CHICAGO IL
60647-4805
US

IV. Provider business mailing address

1757 N KIMBALL AVE STE 202
CHICAGO IL
60647-4805
US

V. Phone/Fax

Practice location:
  • Phone: 331-442-4449
  • Fax:
Mailing address:
  • Phone: 331-442-4449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1922406412
License Number StateIL

VIII. Authorized Official

Name: INGRID V LADDEN
Title or Position: STAFF
Credential: LCSW
Phone: 331-442-4449