Organization
SIPS OF HEALING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAYAL SUD LCSW (PRESIDENT)
(708) 308-0453
Entity
Organization
Contact information
Practice address
58 E CLINTON ST # B30, JOLIET, IL 60432-4143
(708) 308-0453
Mailing address
485 FOXBOROUGH TRL, BOLINGBROOK, IL 60440-4835
(708) 308-0453
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
336782721001
—
IL
Enumeration date
12/22/2019
Last updated
12/22/2019
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