Organization
KIMBALL LADIEN,MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBALL HENRY LADIEN M.D. (PSYCHIATRIST)
(773) 883-0200
Entity
Organization
Contact information
Practice address
938 W NELSON ST, FIRST FLOOR, CHICAGO, IL 60657-6704
(773) 883-0200
(773) 883-0090
Mailing address
938 W NELSON ST, FIRST FLOOR, CHICAGO, IL 60657-6704
(773) 883-0200
(773) 883-0090
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036076843
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036076843
—
IL
Enumeration date
06/22/2010
Last updated
06/22/2010
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