Organization
PSYCHIATRY SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA RATCLIFFE (OFFICER)
(773) 239-9600
Entity
Organization
Contact information
Practice address
855 W 103RD ST, SUITE 100, CHICAGO, IL 60643-2357
(773) 239-9600
Mailing address
4535 N BEACON ST, CHICAGO, IL 60640-5518
(773) 239-9600
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
036121844
IL
261QM0850X
Adult Mental Health Clinic/Center
036121844
IL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
036121844
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036121844
—
IL
Enumeration date
04/10/2012
Last updated
04/10/2012
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