Organization
ASCENSION HEALTH
Active
Other names
Amita Health
Organization subpart
No
Provider details
NPI number
Authorized official
NORMITA NICOLE DONALDSON (BEHAVIORAL HEALTH TECH)
(773) 842-4042
Entity
Organization
Contact information
Practice address
1414 MAIN ST, MELROSE PARK, IL 60160-3902
(708) 681-0073
Mailing address
1414 MAIN ST, MELROSE PARK, IL 60160-3902
(708) 681-0073
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/27/2023
Last updated
06/27/2023
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