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General NPI Number Information
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NPI Number | 1821459165
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Entity Type | Organization
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Legal Business Name | MILATES CENTER FOR WELL-BEING INC.
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Dates
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Enumeration Date | 03/15/2016
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Last Update Date | 07/21/2016
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Provider Practice Location Address
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Address Line | 155 N MICHIGAN AVE 334
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City | CHICAGO
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State | IL
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Zip | 60601-7511
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Country | US
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Telephone | 312-918-2777
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Fax |
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Provider Business Mailing Address
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Address Line | 474 N LAKE SHORE DR 2004
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City | CHICAGO
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State | IL
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Zip | 60611-6463
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Country | US
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Telephone | 312-918-2777
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MR. MARKO MIHAILOVIC
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Credential | LCPC
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Telephone | 773-816-4228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180010141
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License Number State | IL
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