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General NPI Number Information
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NPI Number | 1306476346
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Entity Type | Organization
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Legal Business Name | ERIKSON INSTITUTE
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Dates
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Enumeration Date | 01/17/2020
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Last Update Date | 01/17/2020
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Provider Practice Location Address
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Address Line | 3948 W 26TH ST
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City | CHICAGO
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State | IL
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Zip | 60623
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Country | US
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Telephone | 312-893-7119
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Fax |
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Provider Business Mailing Address
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Address Line | 451 N LASALLE ST
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City | CHICAGO
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State | IL
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Zip | 60654-4510
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT FOR FINANCE AND OPER
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Name | PATRICIA LAWSON
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Credential |
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Telephone | 312-893-7120
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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 |
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License Number State |
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