| Self Design, Inc | |
|
1007 Church St Suite 515 Evanston IL 60201-3624 | |
| (773) 818-6800 | |
| Not Available |
| Full Name | Self Design, Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1007 Church St, Evanston, Illinois |
| Authorized Official Name and Position | Julie Blackman (PRESIDENT/OWNER) |
| Authorized Official Contact | 7738186800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Self Design, Inc 1007 Church St Suite 515 Evanston IL 60201-3624 Ph: (773) 818-6800 | Self Design, Inc 1007 Church St Suite 515 Evanston IL 60201-3624 Ph: (773) 818-6800 |
| NPI Number | 1023374261 |
|---|---|
| Provider Enumeration Date | 04/02/2012 |
| Last Update Date | 04/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023374261 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149.006816 (Illinois) | Primary |
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