Healthcare Provider Details

I. General information

NPI: 1871112417
Provider Name (Legal Business Name): VULNUS & CURA PSYCHOTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 05/06/2020
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N MICHIGAN AVE
CHICAGO IL
60602-3402
US

IV. Provider business mailing address

920 W CULLOM AVE APT 1R
CHICAGO IL
60613-1632
US

V. Phone/Fax

Practice location:
  • Phone: 708-271-5112
  • Fax:
Mailing address:
  • Phone: 708-271-5112
  • 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: JOEY REA
Title or Position: BUSINESS OWNER
Credential: PSY.D.
Phone: 708-271-5112