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General NPI Number Information
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NPI Number | 1497313423
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Entity Type | Organization
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Legal Business Name | CHICAGO CENTER FOR SEXUAL WELLBEING, LTD.
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Dates
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Enumeration Date | 06/04/2019
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Last Update Date | 06/04/2019
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Provider Practice Location Address
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Address Line | 1945 W WILSON AVE STE 5115
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City | CHICAGO
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State | IL
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Zip | 60640-5258
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Country | US
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Telephone | 773-251-7316
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Fax |
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Provider Business Mailing Address
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Address Line | 1945 W WILSON AVE STE 5115
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City | CHICAGO
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State | IL
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Zip | 60640-5258
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Country | US
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Telephone | 773-251-7316
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/OWNER
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Name | MICHELE DAY
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Credential | LCSW, CSAT
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Telephone | 773-251-7316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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