Healthcare Provider Details

I. General information

NPI: 1457276560
Provider Name (Legal Business Name): EXHALE INTEGRATIVE THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 E WASHINGTON ST STE 1801
CHICAGO IL
60602-1828
US

IV. Provider business mailing address

25 E WASHINGTON ST STE 1801
CHICAGO IL
60602-1828
US

V. Phone/Fax

Practice location:
  • Phone: 317-758-7760
  • Fax:
Mailing address:
  • Phone: 317-758-7760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ELLEN FAY GEDDES
Title or Position: MANAGER
Credential: PSYD
Phone: 480-980-3730