Organization
BEVERLY BEHAVIORAL HEALTH, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI E POWELL MD (PRESIDENT)
(773) 779-9700
Entity
Organization
Contact information
Practice address
9933 S WESTERN AVE, SUITE 104, CHICAGO, IL 60643-1810
(773) 779-9700
(773) 779-9732
Mailing address
9933 S WESTERN AVE, SUITE 104, CHICAGO, IL 60643-1810
(773) 779-9700
(773) 779-9732
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
060-009832
IL
Other
Enumeration date
04/24/2008
Last updated
04/30/2009
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