| Hyssop Modification Services,inc | |
|
5835 W Division St Chicago IL 60651-1008 | |
| (773) 626-3613 | |
| Not Available |
| Full Name | Hyssop Modification Services,inc |
|---|---|
| Speciality | Psychologist |
| Location | 5835 W Division St, Chicago, Illinois |
| Authorized Official Name and Position | Larysa Maria Mykytiuk (MAIN DOCTOR) |
| Authorized Official Contact | 7736263613 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hyssop Modification Services,inc 5835 W Division St Chicago IL 60651-1008 Ph: (773) 626-3613 | Hyssop Modification Services,inc 5835 W Division St Chicago IL 60651-1008 Ph: (773) 626-3613 |
| NPI Number | 1740200682 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740200682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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