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General NPI Number Information
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NPI Number | 1942156831
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Entity Type | Organization
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Legal Business Name | NMWR CHICAGO LLC
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Dates
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Enumeration Date | 03/05/2026
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Last Update Date | 03/07/2026
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Provider Practice Location Address
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Address Line | 3151 N HALSTED ST
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City | CHICAGO
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State | IL
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Zip | 60657-4435
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Country | US
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Telephone | 312-635-5229
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Fax | 877-466-4123
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Provider Business Mailing Address
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Address Line | 3151 N HALSTED ST
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City | CHICAGO
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State | IL
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Zip | 60657-4435
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Country | US
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Telephone | 312-635-5229
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Fax | 877-466-4123
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Authorized Official
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Title or Position | CEO
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Name | PAULO GRAYSON
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Credential |
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Telephone | 310-892-0535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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