Organization
ALLIANCE HEALTH CARE MANAGENENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILNESSA MIMS (MANAGER)
(773) 619-9932
Entity
Organization
Contact information
Practice address
1304 W 77TH ST, CHICAGO, IL 60620-3730
(773) 994-9631
(773) 783-6058
Mailing address
1304 W 77TH ST, CHICAGO, IL 60620-3730
(773) 994-9631
(773) 783-6058
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1119430
IL
Other
Enumeration date
01/18/2009
Last updated
01/18/2009
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