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General NPI Number Information
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NPI Number | 1851826606
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Entity Type | Organization
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Legal Business Name | AM THERAPY PRACTICE PC
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Dates
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Enumeration Date | 04/28/2017
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 2227 N WESTERN AVE STE 1
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City | CHICAGO
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State | IL
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Zip | 60647-3122
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Country | US
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Telephone | 630-566-3529
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Fax |
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Provider Business Mailing Address
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Address Line | 2227 N WESTERN AVE STE 1
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City | CHICAGO
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State | IL
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Zip | 60647-3122
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Country | US
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Telephone | 630-566-3529
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMBER BOUDA
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Credential | LCSW
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Telephone | 630-566-3529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 149.014578
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License Number State | IL
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