Organization
FLUTTERBY VENTURES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA LYNNE MCKINZIE PSYD (CLINICAL PSYCHOLOGIST)
(847) 563-0502
Entity
Organization
Contact information
Practice address
3600 N LAKE SHORE DR, CHICAGO, IL 60613-4684
(847) 563-0502
Mailing address
3600 N LAKE SHORE DR APT 2608, CHICAGO, IL 60613-4666
(847) 563-0502
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528628484
—
IL
Enumeration date
07/08/2021
Last updated
04/18/2023
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