Organization
COLIN F. ENNIS PSYD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLIN F ENNIS PSYD (OWNER)
(312) 725-9745
Entity
Organization
Contact information
Practice address
333 N MICHIGAN AVE, SUITE 711, CHICAGO, IL 60601-3901
(312) 725-9745
(312) 488-3642
Mailing address
3450 N LAKE SHORE DR, #515, CHICAGO, IL 60657-2874
(312) 725-9745
(312) 488-3642
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
071-008031
IL
Other
Enumeration date
07/27/2011
Last updated
07/27/2011
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