Organization
PSYCHOLOGICAL SERVICES OF CHICAGO LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA BAUTISTA PSY.D. (CLINICAL PSYCHOLOGIST/OWNER)
(312) 909-6766
Entity
Organization
Contact information
Practice address
1300 W BELMONT AVE, SUITE 304, CHICAGO, IL 60657-3200
(312) 909-6766
(773) 227-4773
Mailing address
1300 W BELMONT AVE, SUITE 304, CHICAGO, IL 60657-3200
(312) 909-6766
(773) 227-4773
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071007551
IL
Other
Enumeration date
05/15/2012
Last updated
11/19/2012
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