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General NPI Number Information
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NPI Number | 1629392279
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Entity Type | Organization
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Legal Business Name | AMERICAN HOLISTIC PSYCHIATRY SC
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Dates
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Enumeration Date | 03/24/2010
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Last Update Date | 03/24/2010
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Provider Practice Location Address
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Address Line | 1857 W DIVERSEY PKWY 201
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City | CHICAGO
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State | IL
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Zip | 60614-9234
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Country | US
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Telephone | 630-290-2079
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Fax | 773-857-1837
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Provider Business Mailing Address
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Address Line | 1857 W DIVERSEY PKWY 201
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City | CHICAGO
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State | IL
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Zip | 60614-9234
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Country | US
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Telephone | 630-290-2079
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Fax | 773-857-1837
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MOHAMMAD JAVED
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Credential | M.D.
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Telephone | 630-290-2079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036-096828
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License Number State | IL
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