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General NPI Number Information
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NPI Number | 1316249576
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Entity Type | Organization
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Legal Business Name | CORE BEHAVIORAL HEALTH, INC.
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Dates
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Enumeration Date | 11/21/2010
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Last Update Date | 10/30/2020
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Provider Practice Location Address
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Address Line | 1300 W BELMONT AVE SUITE # 504
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City | CHICAGO
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State | IL
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Zip | 60657-3200
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Country | US
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Telephone | 800-994-6602
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Fax | 800-994-6602
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Provider Business Mailing Address
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Address Line | 9217 MONTGOMERY DR
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City | ORLAND PARK
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State | IL
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Zip | 60462-6506
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Country | US
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Telephone | 800-994-6602
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Fax | 800-994-6602
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. RASHID A. RAJA
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Credential | PSY.D.
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Telephone | 800-994-6602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071007541
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License Number State | IL
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