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General NPI Number Information
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NPI Number | 1629181243
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN PSYCHIATRIC WELLNESS, LP
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 11/21/2009
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Provider Practice Location Address
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Address Line | 4711 GOLF RD SUITE 1200
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City | SKOKIE
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State | IL
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Zip | 60076-1224
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Country | US
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Telephone | 224-217-9019
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Fax | 847-770-4484
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Provider Business Mailing Address
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Address Line | 5251 GALITZ ST SUITE 304
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City | SKOKIE
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State | IL
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Zip | 60077-3669
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Country | US
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Telephone | 224-217-9019
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Fax | 847-770-4484
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Authorized Official
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Title or Position | GEN PARTNER
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Name | DR. MARK SHUKHMAN
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Credential | MD
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Telephone | 224-217-9019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric 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 | 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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