Organization
SONIA SHANKMAN ORTHOGENIC SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER G MYERS PSY D (CO-EXECUTIVE DIRECTOR)
(773) 702-1301
Entity
Organization
Contact information
Practice address
1365 E 60TH ST, CHICAGO, IL 60637-2856
(773) 702-1203
(773) 702-1304
Mailing address
1365 E 60TH ST, CHICAGO, IL 60637-2856
(773) 702-1203
(773) 702-1304
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
5734-613-2
IL
Other
Enumeration date
01/07/2009
Last updated
01/07/2009
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