Organization
SANANDUM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN MCCORMACK MBA (CEO)
(312) 719-8208
Entity
Organization
Contact information
Practice address
2 NORTHFIELD PLZ STE 330, NORTHFIELD, IL 60093-1252
(773) 719-1209
Mailing address
2 NORTHFIELD PLZ STE 330, NORTHFIELD, IL 60093-1252
(773) 719-1209
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
104100000X
Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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