Organization
SOUTH SHORE LAKE FRONT SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEONARD GO (DOCTOR)
(773) 375-1900
Entity
Organization
Contact information
Practice address
2619 E 75TH ST # 21, CHICAGO, IL 60649-3705
(773) 375-1900
(773) 785-2091
Mailing address
2619 E 75TH ST # 21, CHICAGO, IL 60649-3705
(773) 375-1900
(773) 785-2091
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
IL
Other
Enumeration date
07/13/2006
Last updated
02/08/2008
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