Healthcare Provider Details

I. General information

NPI: 1497616353
Provider Name (Legal Business Name): CENTER FOR TRANSFORMATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8123 S COTTAGE GROVE AVE
CHICAGO IL
60619-5103
US

IV. Provider business mailing address

8123 S COTTAGE GROVE AVE
CHICAGO IL
60619-5103
US

V. Phone/Fax

Practice location:
  • Phone: 773-968-4222
  • Fax:
Mailing address:
  • Phone: 773-968-4222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: AMER MOSTAFA
Title or Position: PRESIDENT
Credential:
Phone: 773-968-4222