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General NPI Number Information
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NPI Number | 1255632097
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Entity Type | Organization
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Legal Business Name | MARY WORDEN-MCGUINNESS
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Dates
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Enumeration Date | 11/10/2010
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Last Update Date | 11/10/2010
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Provider Practice Location Address
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Address Line | 5310 N SHERIDAN RD
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City | CHICAGO
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State | IL
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Zip | 60640-2514
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Country | US
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Telephone | 312-671-4499
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Fax | 888-457-9315
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Provider Business Mailing Address
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Address Line | 2901 S MICHIGAN AVE APT 402
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City | CHICAGO
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State | IL
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Zip | 60616-3297
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Country | US
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Telephone | 312-671-4499
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Fax | 888-457-9315
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARY E WORDEN-MCGUINNESS
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Credential | PSYD
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Telephone | 312-671-4499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 071005991
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License Number State | IL
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