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NPI 1396400883

NPI 1396400883 : ROCKWELL BEHAVIORAL HEALTH AND WELLNESS : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1396400883
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    Entity Type          |    Organization 
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    Legal Business Name  |    ROCKWELL BEHAVIORAL HEALTH AND WELLNESS 
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Dates
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    Enumeration Date     |    11/01/2021
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    Last Update Date     |    06/05/2025
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Provider Practice Location Address
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    Address Line         |    2334 W LAWRENCE AVE STE 201 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60625-1046
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    Country              |    US
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    Telephone            |    773-756-1733
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2334 W LAWRENCE AVE STE 201 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60625-1046
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    Country              |    US
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    Telephone            |    773-756-1733
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. LOUIS V HAYNES 
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    Credential           |    PSYD
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    Telephone            |    708-381-9352
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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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