Healthcare Provider Details

I. General information

NPI: 1205336088
Provider Name (Legal Business Name): THE RESILIENCE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2018
Last Update Date: 02/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N MICHIGAN AVE STE 1530
CHICAGO IL
60602-3670
US

IV. Provider business mailing address

30 N MICHIGAN AVE STE 1530
CHICAGO IL
60602-3670
US

V. Phone/Fax

Practice location:
  • Phone: 214-603-7297
  • Fax:
Mailing address:
  • Phone: 214-603-7297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071008680
License Number StateIL

VIII. Authorized Official

Name: DR. ALEXIS SILAS
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 214-603-7297