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Organization
DRLULLABY LLC
Active
Organization
DRLULLABY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MEDALIE PSYD (CEO)
(224) 572-8470
Entity
Organization
Contact information
Practice address
400 W ONTARIO STREET, #512, CHICAGO, IL 60654
(224) 572-8470
Mailing address
1440 W TAYLOR ST # 556, CHICAGO, IL 60607-4623
(619) 997-5759
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
NULL
103TB0200X
Cognitive & Behavioral Psychologist
—
—
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/01/2021
Last updated
03/27/2023
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