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General NPI Number Information
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NPI Number | 1215591474
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Entity Type | Organization
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Legal Business Name | GENERATIONS EMPOWERED, INC
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Dates
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Enumeration Date | 04/23/2019
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Last Update Date | 04/23/2019
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Provider Practice Location Address
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Address Line | 2835 N SHEFFIELD AVE STE 407
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City | CHICAGO
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State | IL
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Zip | 60657-5084
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Country | US
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Telephone | 773-789-8034
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Fax |
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Provider Business Mailing Address
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Address Line | 485 FOXBOROUGH TRL
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4835
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Country | US
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Telephone | 708-738-7038
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MS. PAYAL SUD
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Credential | LCSW
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Telephone | 708-308-0453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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