Organization
WISE BEHAVIORAL HEALTH SERVICES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES TRIPP (ADMINISTRATOR)
(773) 510-6165
Entity
Organization
Contact information
Practice address
9012 S CRANDON AVE, CHICAGO, IL 60617-3807
(773) 375-8741
(773) 375-8748
Mailing address
9012 S CRANDON AVE, CHICAGO, IL 60617-3807
(773) 375-8741
(773) 375-8748
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
IL
Other
Enumeration date
01/08/2008
Last updated
01/08/2008
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