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Organization
BEHAVIORAL HEALTH CARE ASSOCIATES LTD
Active
Organization
BEHAVIORAL HEALTH CARE ASSOCIATES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAISE JOSEPH WOLFRUM M.D. (MEDICAL DIRECTOR)
(847) 895-4540
Entity
Organization
Contact information
Practice address
1375 E SCHAUMBURG RD, SUITE 260, SCHAUMBURG, IL 60194-3658
(847) 895-4540
(847) 895-4544
Mailing address
1375 E SCHAUMBURG RD, SUITE 260, SCHAUMBURG, IL 60194-3658
(847) 895-4540
(847) 895-4544
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
036079918
IL
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01619289
BC BS OF ILLINOIS
IL
05
—
036079918
—
IL
Enumeration date
01/29/2007
Last updated
07/21/2022
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