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Organization
WISEMIND CHICAGO, LLC
Active
Organization
WISEMIND CHICAGO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARGO COHN PACTANAC LCSW (PSYCHOTHERAPIST)
(773) 320-5168
Entity
Organization
Contact information
Practice address
5100 N RAVENSWOOD AVE STE 211, CHICAGO, IL 60640-1710
(773) 320-5168
Mailing address
5100 N RAVENSWOOD AVE STE 211, CHICAGO, IL 60640-1710
(773) 320-5168
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149019761
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063794261
INDIVIDUAL NPI NUMBER
OR
Enumeration date
11/06/2017
Last updated
11/06/2017
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