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Organization
SOULU
Active
Organization
SOULU
Active
Other names
Madraigos Midwest
Organization subpart
No
Provider details
NPI number
Authorized official
JAY GREENBERGER LCSW (CLINICAL DIRECTOR)
(773) 478-6000
Entity
Organization
Contact information
Practice address
3557 W PETERSON AVE #122, CHICAGO, IL 60659
(773) 478-6000
(773) 478-6516
Mailing address
3557 W PETERSON AVE #122, CHICAGO, IL 60659
(773) 478-6000
(773) 478-6516
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
Other
Enumeration date
05/04/2016
Last updated
05/04/2016
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