Organization
HYSSOP MODIFICATION SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIA GRIFFIN (MEDICAL BILLER)
(773) 261-5306
Entity
Organization
Contact information
Practice address
5835 W DIVISION ST, CHICAGO, IL 60651-1008
(773) 626-3613
(773) 261-5640
Mailing address
5835 W DIVISION ST, CHICAGO, IL 60651-1008
(773) 626-3613
(773) 261-5640
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
IL
Other
Enumeration date
01/08/2007
Last updated
04/20/2008
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