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General NPI Number Information
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NPI Number | 1164752531
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Entity Type | Organization
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Legal Business Name | CENTER FOR BEHAVIORAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 01/07/2010
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Last Update Date | 07/20/2010
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Provider Practice Location Address
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Address Line | 1851 DOUGLAS RD
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City | MONTGOMERY
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State | IL
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Zip | 60538-2159
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Country | US
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Telephone | 630-844-9900
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Fax | 630-844-9990
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Provider Business Mailing Address
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Address Line | 1851 DOUGLAS RD
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City | MONTGOMERY
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State | IL
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Zip | 60538-2159
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Country | US
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Telephone | 630-844-9900
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Fax | 630-844-9990
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MIRZA BAIG
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Credential |
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Telephone | 773-764-7864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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