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General NPI Number Information
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NPI Number | 1992110217
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Entity Type | Organization
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Legal Business Name | INSIGHT BEHAVIORAL HEALTH CENTERS
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Dates
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Enumeration Date | 06/25/2014
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Last Update Date | 06/25/2014
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Provider Practice Location Address
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Address Line | 200 E OHIO ST B
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City | CHICAGO
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State | IL
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Zip | 60611-7269
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Country | US
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Telephone | 708-288-6327
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E OHIO B
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City | CHICAGO
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State | IL
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Zip | 60642
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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 | CLINICAL DIRECTOR OF RESIDENTIAL TX
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Name | MS. BRITTANY ALEXANDRA STATLER
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Credential | LCSW
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Telephone | 708-288-6327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | 149.016511
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License Number State | IL
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