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Organization

EQUILIBRIUM, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUZANNE SMITH LCSW, CADC (LICENSED CLINICAL SOCIAL WORKER)
(219) 743-9017
Entity
Organization

Contact information

Practice address
53 W JACKSON BLVD STE 1119, CHICAGO, IL 60604-4186
(312) 380-9554
Mailing address
53 W JACKSON BLVD STE 1119, CHICAGO, IL 60604-4186
(312) 380-9554

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1194113308
NPPES
IL
Enumeration date
03/02/2019
Last updated
03/02/2019
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