Organization
FAMILY ADOLESCENT CHILD TREATMENT SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHERINE MARY BOHO PSY.D (CLINICAL DIRECTOR)
(773) 282-2322
Entity
Organization
Contact information
Practice address
4801 W PETERSON AVE, 401, CHICAGO, IL 60646-5713
(773) 282-2322
(773) 282-2853
Mailing address
4801 W PETERSON AVE, 401, CHICAGO, IL 60646-5713
(773) 282-2322
(773) 282-2853
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071004665
IL
Other
Enumeration date
04/02/2012
Last updated
04/02/2012
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