MEDICARE: UNIVERSALL HEALING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1790576544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSALL HEALING

Provider Business Mailing Address
First Line	:	1433 W SUMMERDALE AVE APT 2A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-2188
Country	:	US
Telephone Number	:	312-848-6582
Fax Number	:

Provider Business Practice Location Address
First Line	:	1433 W SUMMERDALE AVE APT 2A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-2188
Country	:	US
Telephone Number	:	312-848-6582
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MISS CALLEN JONES
Credential	:	LCPC, R-DMT
Telephone Number	:	312-848-6582

Provider Enumeration Date	:	05/13/2025
Last Update Date	:	05/13/2025

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Directions to “UNIVERSALL HEALING ” Practice Location

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