| Collected In The Space | |
|
661 W Lake St Ste 2s Chicago IL 60661-1034 | |
| (773) 322-2385 | |
| Not Available |
| Full Name | Collected In The Space |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 661 W Lake St Ste 2s, Chicago, Illinois |
| Authorized Official Name and Position | Carina Bauer (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 7733222385 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Collected In The Space 661 W Lake St Ste 2s Chicago IL 60661-1034 Ph: (773) 322-2385 | Collected In The Space 661 W Lake St Ste 2s Chicago IL 60661-1034 Ph: (773) 322-2385 |
| NPI Number | 1699460691 |
|---|---|
| Provider Enumeration Date | 04/06/2023 |
| Last Update Date | 05/10/2023 |
| Certification Date | 05/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699460691 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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