| Cathartic Space Ltd | |
|
3166 N Lincoln Ave Suite 207 Chicago IL 60657-3133 | |
| (773) 633-9075 | |
| Not Available |
| Full Name | Cathartic Space Ltd |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3166 N Lincoln Ave, Chicago, Illinois |
| Authorized Official Name and Position | Kristen Jacobsen (OWNER) |
| Authorized Official Contact | 7736339075 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cathartic Space Ltd 3166 N Lincoln Ave Suite 207 Chicago IL 60657-3133 Ph: () - | Cathartic Space Ltd 3166 N Lincoln Ave Suite 207 Chicago IL 60657-3133 Ph: (773) 633-9075 |
| NPI Number | 1730579012 |
|---|---|
| Provider Enumeration Date | 01/26/2015 |
| Last Update Date | 01/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730579012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180008355 (Illinois) | Primary |
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