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PHOENIX HEALTHCARE SERVICES LLC NPI 1285680645


NPI Information

NPI: 1285680645
Provider Name: PHOENIX HEALTHCARE SERVICES LLC
Classification: Psychologist - 103TP2701X
Entity Type: Organization

Specialization: Group Psychotherapy

Address:
7324 N WESTERN AVE
CHICAGO, IL
ZIP 60645
Phone: (773) 465-4555
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PHOENIX HEALTHCARE SERVICES LLC is a group psychotherapy psychologist in Chicago, IL. The provider is a psychologist who specializes in group psychology and group psychotherapy that is an evidenced-based specialty that prepares group leaders to identify and capitalize on developmental and healing possibilities embedded in the interpersonal/intrapersonal functioning of individual group members as well as collectively for the group. Emphasis is placed on the use of group dynamics to assist and treat individual group members. The specialty is applicable to all age groups, children, adolescents, adults and older adults, for a wide variety of conditions and concerns, and in numerous and diverse settings. PHOENIX HEALTHCARE SERVICES LLC NPI is 1285680645. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7324 N WESTERN AVE
CHICAGO, IL
ZIP 60645-814
Phone: (773) 465-4555
Fax: (773) 465-4552

The provider's authorized official is Joel Mostow .
The authorized official title is Delegated Official and has the following contact phone number (773) 465-4555.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 4/9/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TP2701XPsychologistGroup PsychotherapyILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1210467MEDICARE ID-TYPE UNSPECIFIEDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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