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General NPI Number Information
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NPI Number | 1669950911
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Entity Type | Organization
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Legal Business Name | CHICAGO PERSONAL GROWTH INSTITUTE
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Dates
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Enumeration Date | 07/30/2018
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Last Update Date | 07/30/2018
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Provider Practice Location Address
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Address Line | 223 W JACKSON BLVD STE 360
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City | CHICAGO
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State | IL
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Zip | 60606-6915
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Country | US
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Telephone | 312-781-9550
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Fax | 312-631-3155
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Provider Business Mailing Address
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Address Line | 223 W JACKSON BLVD STE 360
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City | CHICAGO
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State | IL
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Zip | 60606-6915
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Country | US
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Telephone | 312-781-9550
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Fax | 312-631-3155
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Authorized Official
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Title or Position | PARTNER
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Name | MR. JEFF J STAHL
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Credential | LCPC
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Telephone | 312-636-7516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 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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