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General NPI Number Information
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NPI Number | 1760474993
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Entity Type | Organization
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Legal Business Name | GREATER LAWN MENTAL HEALTH CENTER
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 4150 W 55TH ST GREATER LAWN MENTAL HEALTH CENTER
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City | CHICAGO
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State | IL
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Zip | 60632-4242
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Country | US
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Telephone | 312-747-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 111 W WASHINGTON ST FL 4
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City | CHICAGO
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State | IL
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Zip | 60602-2703
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Country | US
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Telephone | 312-747-9443
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Fax | 312-747-9447
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Authorized Official
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Title or Position | PROJECT MANAGER
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Name | HILLARY WANG
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Credential |
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Telephone | 312-747-8878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | IL
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