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NPI 1538634266

NPI 1538634266 : IKIGAI : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1538634266
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    Entity Type          |    Organization 
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    Legal Business Name  |    IKIGAI 
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Dates
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    Enumeration Date     |    10/09/2018
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    Last Update Date     |    10/09/2018
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Provider Practice Location Address
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    Address Line         |    4208 N CENTRAL PARK AVE 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60618-2020
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    Country              |    US
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    Telephone            |    773-497-2001
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    Fax                  |    312-253-1413
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Provider Business Mailing Address
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    Address Line         |    4208 N CENTRAL PARK AVE 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60618-2020
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    Country              |    US
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    Telephone            |    773-497-2001
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    Fax                  |    312-253-1413
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    MS. NANCY  HEAP 
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    Credential           |    LCSW
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    Telephone            |    224-372-0019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0850X
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    Taxonomy Name        |    Adult Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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