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General NPI Number Information
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NPI Number | 1467074534
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Entity Type | Organization
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Legal Business Name | HOLMES PSYCHIATRY LLC
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Dates
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Enumeration Date | 05/12/2020
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | 2027 W DIVISION ST # 144
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City | CHICAGO
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State | IL
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Zip | 60622-9024
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Country | US
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Telephone | 312-772-3054
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Fax | 267-787-2180
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Provider Business Mailing Address
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Address Line | 2027 W DIVISION ST # 144
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City | CHICAGO
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State | IL
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Zip | 60622-9024
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Country | US
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Telephone | 312-772-3054
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Fax | 267-787-2180
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Authorized Official
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Title or Position | OWNER
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Name | CAROLINE HOLMES
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Credential | MD
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Telephone | 630-885-8672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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