Organization
OPTIMUM QUALITY BEHAVIORAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN CLUKIE (ADMINISTRATOR)
(813) 997-2099
Entity
Organization
Contact information
Practice address
1603 ORRINGTON AVE STE 600, EVANSTON, IL 60201-3860
(813) 997-2099
Mailing address
200 DUNDEE AVE, EAST DUNDEE, IL 60118-1627
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/07/2023
Last updated
08/20/2024
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