| Retake On Life | |
|
9415 S Western Ave Chicago IL 60643-6700 | |
| (773) 998-7848 | |
| Not Available |
| Full Name | Retake On Life |
|---|---|
| Speciality | Counselor - Professional |
| Location | 9415 S Western Ave, Chicago, Illinois |
| Authorized Official Name and Position | Jamillah Davis (LICENSED CLIN PROF COUNSELOR) |
| Authorized Official Contact | 7739987848 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Retake On Life 8008 S Loomis Blvd Chicago IL 60620-3828 Ph: (773) 998-7848 | Retake On Life 9415 S Western Ave Chicago IL 60643-6700 Ph: (773) 998-7848 |
| NPI Number | 1295379279 |
|---|---|
| Provider Enumeration Date | 11/01/2019 |
| Last Update Date | 11/01/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295379279 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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