Organization
LAYNIE FOUNDATION, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUMMER A EWING PHD (C.O.O.)
(708) 617-8548
Entity
Organization
Contact information
Practice address
230 EAST OHIO STREET, SUITE 112, CHICAGO, IL 60611
(312) 929-6860
(708) 617-8017
Mailing address
230 EAST OHIO STREET, SUITE 112, CHICAGO, IL 60611
(312) 929-6860
(708) 617-8017
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2B05-IPI170
—
IL
Enumeration date
06/09/2017
Last updated
06/09/2017
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