Organization
BONFIRE CLINICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATHEW ASHLEY LINDSAY LCSW (CO-PARTNER)
(312) 404-7864
Entity
Organization
Contact information
Practice address
4442 N SAWYER AVE APT 1, CHICAGO, IL 60625-4885
(312) 404-7864
Mailing address
4442 N SAWYER AVE APT 1, CHICAGO, IL 60625-4885
(312) 404-7864
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114087897
—
IL
Enumeration date
08/02/2024
Last updated
08/02/2024
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