| Wisemind Chicago, Llc | |
|
5100 N Ravenswood Ave Ste 211 Chicago IL 60640-1710 | |
| (773) 320-5168 | |
| Not Available |
| Full Name | Wisemind Chicago, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5100 N Ravenswood Ave Ste 211, Chicago, Illinois |
| Authorized Official Name and Position | Margo Cohn Pactanac (PSYCHOTHERAPIST) |
| Authorized Official Contact | 7733205168 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisemind Chicago, Llc 5100 N Ravenswood Ave Ste 211 Chicago IL 60640-1710 Ph: (773) 320-5168 | Wisemind Chicago, Llc 5100 N Ravenswood Ave Ste 211 Chicago IL 60640-1710 Ph: (773) 320-5168 |
| NPI Number | 1710490248 |
|---|---|
| Provider Enumeration Date | 11/06/2017 |
| Last Update Date | 11/06/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710490248 | NPI | - | NPPES |
| 1063794261 | Other | OR | INDIVIDUAL NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149019761 (Illinois) | Primary |
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