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General NPI Number Information
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NPI Number | 1619388196
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Entity Type | Organization
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Legal Business Name | CHICAGO CENTER FOR INTEGRATION AND HEALING LTD
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Dates
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Enumeration Date | 05/19/2014
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 4700 N RAVENSWOOD AVE
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City | CHICAGO
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State | IL
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Zip | 60640-4408
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Country | US
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Telephone | 773-754-7441
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Fax |
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Provider Business Mailing Address
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Address Line | 4700 N RAVENSWOOD AVE
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City | CHICAGO
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State | IL
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Zip | 60640-4408
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Country | US
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Telephone | 773-754-7441
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | AMY ZAJAKOWSKI UHLL
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Credential | LCPC
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Telephone | 773-754-7441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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