Healthcare Provider Details

I. General information

NPI: 1942160742
Provider Name (Legal Business Name): LIMINAL STATES CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 11/22/2025
Certification Date: 11/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 HOLBROOK RD APT 30A
HOMEWOOD IL
60430-4529
US

IV. Provider business mailing address

940 HOLBROOK RD APT 30A
HOMEWOOD IL
60430-4529
US

V. Phone/Fax

Practice location:
  • Phone: 312-291-1978
  • Fax:
Mailing address:
  • Phone:
  • 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: DR. GEOFFREY BATHJE
Title or Position: OWNER
Credential: PHD
Phone: 312-291-1978