Organization
BASARIDA WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AIDARINA BASARUDIN-PIGOTT LCSW (PRESIDENT)
(773) 332-6664
Entity
Organization
Contact information
Practice address
10725 S WESTERN AVE, 2ND FLOOR, CHICAGO, IL 60643-3135
(773) 332-6664
Mailing address
11625 S MAPLEWOOD AVE, CHICAGO, IL 60655-1523
(773) 332-6664
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149014315
IL
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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