Organization
ARCH ANGEL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTUAN DURALL WILBON M.S.W. (CEO/OWNER)
(312) 474-6189
Entity
Organization
Contact information
Practice address
10 S. RIVERSIDE PLAZA, SUITE 875, CHICAGO, IL 60606
(312) 474-6189
(773) 260-1479
Mailing address
10 S. RIVERSIDE PLAZA, SUITE 875, CHICAGO, IL 60606
(312) 474-6189
(773) 260-1479
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/13/2018
Last updated
07/18/2018
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