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General NPI Number Information
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NPI Number | 1497616353
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Entity Type | Organization
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Legal Business Name | CENTER FOR TRANSFORMATION
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 8123 S COTTAGE GROVE AVE
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City | CHICAGO
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State | IL
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Zip | 60619-5103
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Country | US
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Telephone | 773-968-4222
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Fax |
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Provider Business Mailing Address
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Address Line | 8123 S COTTAGE GROVE AVE
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City | CHICAGO
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State | IL
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Zip | 60619-5103
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Country | US
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Telephone | 773-968-4222
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMER MOSTAFA
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Credential |
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Telephone | 773-968-4222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084F0202X
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Taxonomy Name | Forensic Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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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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