| Lincoln Park Therapy Group | |
|
2755 N Pine Grove Ave Chicago IL 60614-6109 | |
| (312) 259-2665 | |
| Not Available |
| Full Name | Lincoln Park Therapy Group |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2755 N Pine Grove Ave, Chicago, Illinois |
| Authorized Official Name and Position | Nicolle Alodia Molina Osequeda (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 3122592665 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lincoln Park Therapy Group 2755 N Pine Grove Ave Chicago IL 60614-6109 Ph: (312) 259-2665 | Lincoln Park Therapy Group 2755 N Pine Grove Ave Chicago IL 60614-6109 Ph: (312) 259-2665 |
| NPI Number | 1144672908 |
|---|---|
| Provider Enumeration Date | 07/05/2016 |
| Last Update Date | 01/25/2021 |
| Certification Date | 01/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144672908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 166000873 (Illinois) | Primary |
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