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General NPI Number Information
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NPI Number | 1841759420
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Entity Type | Organization
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Legal Business Name | PARENT CHILD CATALYST LLC
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 03/13/2019
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Provider Practice Location Address
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Address Line | 3047 N LINCOLN AVE UNIT 400
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City | CHICAGO
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State | IL
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Zip | 60657-4274
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Country | US
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Telephone | 773-505-1967
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Fax |
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Provider Business Mailing Address
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Address Line | 3047 N LINCOLN AVE UNIT 400
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City | CHICAGO
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State | IL
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Zip | 60657-4274
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Country | US
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Telephone | 773-505-1967
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MEGHAN EDMUNDSON
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Credential | MD
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Telephone | 773-505-1967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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