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Organization

REALITY TALK, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DIANE WASHINGTON M.D. (PRESIDENT)
(630) 328-3571
Entity
Organization

Contact information

Practice address
1808 S STATE ST, CHICAGO, IL 60616-1611
(312) 949-1340
(312) 949-1348
Mailing address
1507 E 53RD ST, #275, CHICAGO, IL 60615-4573
(630) 328-3571

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
036-085290
IL
261QM0850X
Adult Mental Health Clinic/Center
Primary
036-085290
IL

Other

Enumeration date
04/28/2011
Last updated
04/28/2011
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