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General NPI Number Information
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NPI Number | 1104464916
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Entity Type | Organization
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Legal Business Name | MAINSAIL THERAPEUTICS LLC
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Dates
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Enumeration Date | 12/12/2019
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Last Update Date | 12/12/2019
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Provider Practice Location Address
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Address Line | 2551 N CLARK ST STE 800
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City | CHICAGO
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State | IL
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Zip | 60614-4984
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Country | US
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Telephone | 312-257-8550
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Fax |
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Provider Business Mailing Address
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Address Line | 333 N OAK PARK AVE
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City | OAK PARK
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State | IL
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Zip | 60302-2120
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Country | US
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Telephone | 217-246-0714
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SETH FRANZ
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Credential |
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Telephone | 217-246-0714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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