| North Side Psychiatry | |
|
2001 N Halsted St Ste 304 Chicago IL 60614-4365 | |
| (312) 612-9667 | |
| (312) 872-7660 |
| Full Name | North Side Psychiatry |
|---|---|
| Speciality | Clinic/Center |
| Location | 2001 N Halsted St Ste 304, Chicago, Illinois |
| Authorized Official Name and Position | Dylan Kathol (PSYCHIATRIST) |
| Authorized Official Contact | 3126129667 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Side Psychiatry 2001 N Halsted St Ste 304 Chicago IL 60614-4365 Ph: (312) 612-9667 | North Side Psychiatry 2001 N Halsted St Ste 304 Chicago IL 60614-4365 Ph: (312) 612-9667 |
| NPI Number | 1245831569 |
|---|---|
| Provider Enumeration Date | 11/03/2020 |
| Last Update Date | 03/04/2024 |
| Certification Date | 03/04/2024 |
| Medicare PECOS PAC ID | 9234576695 |
|---|---|
| Medicare Enrollment ID | O20240320002828 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245831569 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Dylan Joseph Kathol |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114345964 PECOS PAC ID: 6002139391 Enrollment ID: I20180725000412 |
Philip K Mccullough Md Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Huron St, Suite 11-100, Chicago, IL 60611 Phone: 312-695-3680 Fax: 312-926-3709 | |
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