Organization
ANDERSONVILLE COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT T BAKER III PSY.D. (CHIEF PSYCHOLOGIST)
(847) 331-4600
Entity
Organization
Contact information
Practice address
5412 N CLARK ST, SUITE 210, CHICAGO, IL 60640-1272
(847) 331-4600
(773) 409-5590
Mailing address
5315 N CLARK ST, STE 319, CHICAGO, IL 60640-2290
(847) 331-4600
(773) 409-5590
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071006239
IL
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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