Organization
MC DERMOTT CENTER
Active
Other names
Haymarket Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAN LUSTIG PSY. D (PRESIDENT/CEO)
(312) 226-7984
Entity
Organization
Contact information
Practice address
108 N SANGAMON ST FL 3, CHICAGO, IL 60607-2202
(312) 226-7984
(312) 226-8048
Mailing address
932 W WASHINGTON BLVD, CHICAGO, IL 60607-2217
(312) 226-7984
(312) 226-8048
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
17001
IL
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0349-0056
—
IL
Enumeration date
01/25/2017
Last updated
04/02/2025
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