Healthcare Provider Details

I. General information

NPI: 1639848567
Provider Name (Legal Business Name): SPRING ADVISORY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2021
Last Update Date: 09/13/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 N SOUTHPORT AVE # 300
CHICAGO IL
60657-1475
US

IV. Provider business mailing address

3501 N SOUTHPORT AVE # 300
CHICAGO IL
60657-1475
US

V. Phone/Fax

Practice location:
  • Phone: 312-380-1713
  • Fax:
Mailing address:
  • Phone: 312-380-1713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. SHAN RU LIN
Title or Position: MANAGER
Credential: LCPC ATRBC ATCS
Phone: 609-529-0708