Organization
WAKEFUL PRACTICE, LLC
Active
Other names
Wakeful Practice
Organization subpart
No
Provider details
NPI number
Authorized official
AMY B. KALLENBERG LCSW (OWNER/PSYCHOTHERAPIST)
(312) 625-3373
Entity
Organization
Contact information
Practice address
4054 N LINCOLN AVE STE 2, CHICAGO, IL 60618-3144
(312) 625-3373
Mailing address
4018 N LAWLER AVE, CHICAGO, IL 60641-1733
(312) 625-3373
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/13/2018
Last updated
08/09/2024
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