| Center For Self-actualization | |
|
3317 W 95th St Suite 101 Evergreen Park IL 60805-2243 | |
| (312) 927-0216 | |
| Not Available |
| Full Name | Center For Self-actualization |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3317 W 95th St, Evergreen Park, Illinois |
| Authorized Official Name and Position | Tammy Rohan Bobel (DIRECTOR) |
| Authorized Official Contact | 3129270216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Self-actualization 3317 W 95th St Suite 101 Evergreen Park IL 60805-2243 Ph: (312) 927-0216 | Center For Self-actualization 3317 W 95th St Suite 101 Evergreen Park IL 60805-2243 Ph: (312) 927-0216 |
| NPI Number | 1922423508 |
|---|---|
| Provider Enumeration Date | 02/19/2014 |
| Last Update Date | 02/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922423508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180008956 (Illinois) | Secondary |
| 101YP2500X | Counselor - Professional | 180008083 (Illinois) | Primary |
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