Organization
INSTITUTE FOR BEHAVIORAL HEALTH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA YATES LCSW (PRESIDENT)
(773) 404-0160
Entity
Organization
Contact information
Practice address
1373 W CHICAGO AVE, CHICAGO, IL 60622-5761
(773) 477-1872
Mailing address
4250 N MARINE DR APT 1521, CHICAGO, IL 60613-1714
(773) 404-0160
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
IL
Other
Enumeration date
07/02/2007
Last updated
12/06/2007
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