Organization
GOLD COAST CLINICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BABATUNDE GBOLADE OKULEYE M.D, MBA (PRESIDENT)
(773) 350-0020
Entity
Organization
Contact information
Practice address
845 N MICHIGAN AVE, SUITE 917W, CHICAGO, IL 60611-2252
(312) 291-8063
(312) 291-8369
Mailing address
845 N MICHIGAN AVE, SUITE 917W, CHICAGO, IL 60611-2252
(312) 291-8063
(312) 291-8369
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
036098130
IL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
036098130
IL
Other
Enumeration date
01/04/2012
Last updated
01/04/2012
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