Organization
LILAC TREATMENT CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILL GIKOPOULOS (PRESIDENT)
(847) 530-6266
Entity
Organization
Contact information
Practice address
5318-24 W LAWRENCE AVE, CHICAGO, IL 60630-3618
(773) 236-8496
(773) 236-8497
Mailing address
5318-24 W LAWRENCE AVE, CHICAGO, IL 60630-3618
(773) 236-8496
(773) 236-8497
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091684
—
IL
01
—
1679606560
NPI - DR. PUSZKARSKI
IL
Enumeration date
11/17/2010
Last updated
11/17/2010
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