Healthcare Provider Details

I. General information

NPI: 1790527026
Provider Name (Legal Business Name): ACCEPT & AWAKEN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2024
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 W WASHINGTON BLVD STE 240
CHICAGO IL
60661-2695
US

IV. Provider business mailing address

560 W WASHINGTON BLVD STE 240
CHICAGO IL
60661-2695
US

V. Phone/Fax

Practice location:
  • Phone: 312-274-2089
  • Fax: 312-761-8900
Mailing address:
  • Phone: 312-274-2089
  • Fax: 312-761-8900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LINDSAY SHERMAN
Title or Position: PRACTICE OWNER
Credential: LCPC
Phone: 312-274-2089