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Organization
AUTUMN HEALTHCARE OF ILLINOIS
Active
Organization
AUTUMN HEALTHCARE OF ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA ANN BRAZELTON-SYKES MS (EXECUTIVE DIRECTOR)
(773) 420-3481
Entity
Organization
Contact information
Practice address
4505 S DREXEL BLVD, CHICAGO, IL 60653-4301
(773) 285-0550
Mailing address
9449 S KEDZIE AVE, STE142, EVERGREEN PARK, IL 60805-2325
(773) 420-3481
(773) 420-3597
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487709697
NPI
IL
01
—
207655
NO TITLE
IL
Enumeration date
01/25/2007
Last updated
04/23/2025
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