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General NPI Number Information
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NPI Number | 1801460548
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Entity Type | Organization
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Legal Business Name | DOKKO WELLNESS SERVICES LLC
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Dates
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Enumeration Date | 05/17/2021
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Last Update Date | 05/17/2021
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Provider Practice Location Address
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Address Line | 17 N WABASH AVE STE 515
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City | CHICAGO
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State | IL
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Zip | 60602-4818
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Country | US
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Telephone | 773-809-3528
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Fax |
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Provider Business Mailing Address
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Address Line | 6711 N LORON AVE
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City | CHICAGO
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State | IL
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Zip | 60646-1409
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Country | US
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Telephone | 303-810-3144
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. AIMEE DOKKO OSBORNE
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Credential | LCPC, NCC
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Telephone | 773-809-3528
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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 |
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