Organization
GATHER SPARKS CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DAVID COLOMBATTO PSY.D. (CLINICAL PSYCHOLOGIST)
(312) 859-6512
Entity
Organization
Contact information
Practice address
180 N MICHIGAN AVE, SUITE 1910C, CHICAGO, IL 60601-7401
(312) 859-6512
Mailing address
600 S DEARBORN ST APT 1211, CHICAGO, IL 60605-1895
(312) 859-6512
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071005566
IL
Other
Enumeration date
05/08/2010
Last updated
12/03/2010
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