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General NPI Number Information
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NPI Number | 1699639435
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Entity Type | Organization
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Legal Business Name | AMANA BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 12/15/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 1255 S STATE ST UNIT 1416
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City | CHICAGO
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State | IL
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Zip | 60605-3580
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Country | US
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Telephone | 312-809-9747
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Fax |
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Provider Business Mailing Address
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Address Line | 1440 W TAYLOR ST STE 4310
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City | CHICAGO
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State | IL
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Zip | 60607-4623
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Country | US
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Telephone | 312-809-9747
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | MOHAMMED ISMAIL
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Credential | MD
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Telephone | 312-809-9747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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