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6721 W. 40th Street Stickney IL 60402-4174 | |
| (708) 237-8918 | |
| (708) 237-8997 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 6721 W. 40th Street, Stickney, Illinois |
| Authorized Official Name and Position | Christopher Grunow (HEALTH DIRECTOR) |
| Authorized Official Contact | 7084249200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5635 State Rd Burbank IL 60459-2051 Ph: (708) 237-8918 | 6721 W. 40th Street Stickney IL 60402-4174 Ph: (708) 237-8918 |
| NPI Number | 1467918417 |
|---|---|
| Provider Enumeration Date | 02/14/2019 |
| Last Update Date | 12/20/2024 |
| Certification Date | 12/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467918417 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
Stickney Public Health District Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6721 40th St, Stickney, IL 60402 Phone: 708-788-9100 Fax: 708-788-4856 |