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General NPI Number Information
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NPI Number | 1962386730
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Entity Type | Organization
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Legal Business Name | SUNFLOWER CLINICAL GROUP LTD
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1740 RIDGE AVE STE LL15A
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City | EVANSTON
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State | IL
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Zip | 60201-5919
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Country | US
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Telephone | 312-877-9411
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Fax |
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Provider Business Mailing Address
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Address Line | 1740 RIDGE AVE STE LL15A
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City | EVANSTON
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State | IL
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Zip | 60201-5919
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND CHIEF PSYCHOTHERAPIST
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Name | JACOB HOGAN
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Credential | LCSW
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Telephone | 312-877-9411
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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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